Factors predicting change in hospital safety climate and capability in a multi-site patient safety collaborative: a longitudinal survey study

Abstract

A range of social, cultural and organisational factors may be sensitive to this type of intervention but the measurable effect is small. Supporting critical local programme implementation factors may be an effective strategy in achieving development in organisational patient SCC, regardless of contextual factors and organisational preconditions.

Evaluation of a continuous monitoring and feedback initiative to improve quality of anaesthetic care: a mixed-methods quasi-experimental study

“…Implementation factors associated with quality improvement interventions have been shown to be particularly powerful. 76 The reasons for the decrease in perceptions at the primary site between basic and enhanced feedback may be more complex. It may be the case that anaesthetists developed higher expectations from the feedback as the project developed and, therefore, rated it more critically when completing the survey for the third time.…”

“…[64][65][66][67][68][69][70][71][72][73] Drawing on the evolving improvement science discipline, 74,75 in the UK and elsewhere, a number of national and local initiatives have been launched to improve care through the application of industry-derived quality improvement methods. 76,77 Such programmes adopt a Continuous Quality Improvement philosophy 78,79 and often employ statistical process control as a measurement and evaluation model to guide improvement activities.…”

“…76,153 As mentioned previously, the survey measure comprised four items assessing the comprehensiveness of local quality monitoring, that is whether or not clinicians received regular quantitative feedback on a number of individual quality dimensions. These items were summed into a scale representing comprehensiveness of monitoring for the purposes of the regression analysis.…”

“…107,144 Such effects have been displayed in terms of reduction of mortality rates and improved compliance with guidelines, among other outcomes. 76,[145][146][147] A number of important characteristics for effective feedback have been suggested by prior research, including the perceived validity and credibility of the data; their source and timeliness; the way units are benchmarked and the avoidance of individual profiling that could be misconstrued as punitive. 97 Tailoring feedback to the specific clinical setting has been shown to have a positive influence on its effectiveness along with ensuring that those issuing the feedback are perceived as experts.…”

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

“…Despite having a basic improvement approach in common, the differences in scale and scope of the patient safety programmes impact on both the complexity of their implementation and the evaluation of their outcomes 5,168,[212][213][214][215] and the reported outcomes of these interventions are marked by considerable variation. However, although public inquiries and research evidence now concur that patient safety is, in part, a matter of context, 168 there has been very limited systematic and independent analysis of the relationship between organisational factors which shape the local context of health care and the outcomes of patient safety interventions.…”