Improving patient preparedness for the operating room: A quality improvement study in Winchester District Memorial Hospital – A rural hospital in Ontario

Gazarin, Mohamed; Mulligan, Emily; Davey, Michelle; Lydiatt, K; O’Neill, C.; Weekes, Kirsti

doi:10.4103/cjrm.cjrm_27_18

Cited by 2 publications

(3 citation statements)

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“…Based on shared decisions over the healthcare processes to be audited, professionals feel legitimised in giving each other feedback: they feel justified and empowered in challenging each other, including professionals PLOS ONE who are perceived as higher up the hierarchy [72]. In some cases, lack of improvement was a result of dissonant relationships between various departments as they are often unaware of each other's duties and responsibilities [94]. The audit process thus flattens the perceived hierarchy and encourages constructive collaboration [46,61,94,115].…”

Section: Cmoc7 Audits Legitimise the Provision Of Feedback To Colleamentioning

confidence: 99%

“…In some cases, lack of improvement was a result of dissonant relationships between various departments as they are often unaware of each other's duties and responsibilities [94]. The audit process thus flattens the perceived hierarchy and encourages constructive collaboration [46,61,94,115]. It should be noted that this mechanism of a flattened perceived hierarchy only 'works' in a context where the learning culture is considered safe.…”

Section: Cmoc7 Audits Legitimise the Provision Of Feedback To Colleamentioning

confidence: 99%

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Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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Background Several types of audits have been used to promote quality improvement (QI) in hospital care. However, in-depth studies into the mechanisms responsible for the effectiveness of audits in a given context is scarce. We sought to understand the mechanisms and contextual factors that determine why audits might, or might not, lead to improved quality of hospital care. Methods A realist review was conducted to systematically search and synthesise the literature on audits. Data from individual papers were synthesised by coding, iteratively testing and supplementing initial programme theories, and refining these theories into a set of context–mechanism–outcome configurations (CMOcs). Results From our synthesis of 85 papers, seven CMOcs were identified that explain how audits work: (1) externally initiated audits create QI awareness although their impact on improvement diminishes over time; (2) a sense of urgency felt by healthcare professionals triggers engagement with an audit; (3) champions are vital for an audit to be perceived by healthcare professionals as worth the effort; (4) bottom-up initiated audits are more likely to bring about sustained change; (5) knowledge-sharing within externally mandated audits triggers participation by healthcare professionals; (6) audit data support healthcare professionals in raising issues in their dialogues with those in leadership positions; and (7) audits legitimise the provision of feedback to colleagues, which flattens the perceived hierarchy and encourages constructive collaboration. Conclusions This realist review has identified seven CMOcs that should be taken into account when seeking to optimise the design and usage of audits. These CMOcs can provide policy makers and practice leaders with an adequate conceptual grounding to design contextually sensitive audits in diverse settings and advance the audit research agenda for various contexts. PROSPERO registration CRD42016039882.

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Section: Cmoc7 Audits Legitimise the Provision Of Feedback To Colleamentioning

confidence: 99%

Section: Cmoc7 Audits Legitimise the Provision Of Feedback To Colleamentioning

confidence: 99%

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

et al. 2021

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“…In some studies, the quality of care has been shown to improve through facilitating more timely access to the right care by the right person in the right place [ 6 , 20 , 27 , 28 ]. Quality initiatives have also been shown to increase provider efficiency [ 7 ] and local team function [ 5 , 19 , 29 ] and increase adherence to best practice guidelines and clinical protocols [ 6 , 29 ], in some instances resulting in reduced costs [ 6 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

A mixed-methods descriptive study on the role of continuous quality improvement in rural surgical and obstetrical stability: Considering enablers, challenges and impact

Kornelsen,

Cameron,

Stoll

et al. 2024

PLoS ONE

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Introduction The Rural Surgical Obstetrical Networks (RSON) initiative in BC was developed to stabilize and grow low volume rural surgical and obstetrical services. One of the wrap-around supportive interventions was funding for Continuous Quality Improvement (CQI) initiatives, done through a local provider-driven lens. This paper reviews mixed-methods findings on providers’ experiences with CQI and the implications for service stability. Background Small, rural hospitals face barriers in implementing quality improvement initiatives due primarily to lack of resource capacity and the need to prioritize clinical care when allocating limited health human resources. Given this, funding and resources for CQI were key enablers of the RSON initiative and seen as an essential part of a response to assuaging concerns of specialists at higher volume sites regarding quality in lower volume settings. Methods Data were derived from two datasets: in-depth, qualitative interviews with rural health care providers and administrators over the course of the RSON initiative and through a survey administered at RSON sites in 2023. Findings Qualitative findings revealed participants’ perceptions of the value of CQI (including developing expanded skillsets and improved team function and culture), enablers (the organizational infrastructure for CQI projects), challenges in implementation (complications in protecting/prioritizing CQI time and difficulty with staff engagement) and the importance of local leadership. Survey findings showed high ratings for elements of team function that relate directly to CQI (team process and relationships). Conclusion Attention to effective mechanisms of CQI through a rural lens is essential to ensure that initiatives meet the contextual realities of low-volume sites. Instituting pathways for locally-driven quality improvement initiatives enhances team function at rural hospitals through creating opportunities for trust building and goal setting, improving communication and increasing individual and team-wide motivation to improve patient care.

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Improving patient preparedness for the operating room: A quality improvement study in Winchester District Memorial Hospital – A rural hospital in Ontario

Cited by 2 publications

References 1 publication

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

Understanding how and why audits work in improving the quality of hospital care: A systematic realist review

A mixed-methods descriptive study on the role of continuous quality improvement in rural surgical and obstetrical stability: Considering enablers, challenges and impact

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