Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway

Borghini, Alice; Corazza, Ilaria; Nuti, Sabina

doi:10.3390/ijerph18041481

Cited by 7 publications

(8 citation statements)

References 27 publications

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“…In six articles, the criteria for the selection of PDs were unclear or unspecified [ 39 , 47 , 50 , 76 , 143 , 145 ] and in the remaining papers, the selection of PDs does not apply as they are systematic reviews [ 20 , 57 , 59 , 63 ] and adoption program papers that are implemented based on best practices identified from other positive deviant practices [ 28 , 51 , 54 , 67 , 92 , 119 ]. However, performance-based criteria have been used to identify PDs at individual, health facility or health system levels in majority of the articles [ 11 , 23 , 24 , 26 , 27 , 30 , 32 , 33 , 35 – 38 , 40 – 46 , 48 , 53 , 55 , 56 , 60 – 62 , 65 , 66 , 68 – 75 , 77 , 78 , 80 – 88 , 90 , 93 , 95 – 97 , 99 – 105 , 107 – 118 , 121 , 122 , 124 – 142 , 144 ].…”

Section: Resultsmentioning

confidence: 99%

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

Kassie,

Eakin,

Abate

et al. 2024

BMC Health Serv Res

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Background Quality has been a persistent challenge in the healthcare system, particularly in resource-limited settings. As a result, the utilization of innovative approaches is required to help countries in their efforts to enhance the quality of healthcare. The positive deviance (PD) approach is an innovative approach that can be utilized to improve healthcare quality. The approach assumes that solutions to problems are already available within the community and identifying and sharing those solutions can help others to resolve existing issues. Therefore, this scoping review aimed to synthesize the evidence regarding the use of the PD approach in healthcare system service delivery and quality improvement programs. Methods Articles were retrieved from six international databases. The last date for article search was June 02, 2023, and no date restriction was applied. All articles were assessed for inclusion through a title and/or abstract read. Then, articles that passed the title and abstract review were screened by reading their full texts. In case of duplication, only the full-text published articles were retained. A descriptive mapping and evidence synthesis was done to present data with the guide of the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist and the results are presented in text, table, and figure formats. Results A total of 125 articles were included in this scoping review. More than half, 66 (52.8%), of the articles were from the United States, 11(8.8%) from multinational studies, 10 (8%) from Canada, 8 (6.4%) from the United Kingdom and the remaining, 30 (24%) are from other nations around the world. The scoping review indicates that several types of study designs can be applied in utilizing the PD approach for healthcare service and quality improvement programs. However, although validated performance measures are utilized to identify positive deviants (PDs) in many of the articles, some of the selection criteria utilized by authors lack clarity and are subject to potential bias. In addition, several limitations have been mentioned in the articles including issues in operationalizing PD, focus on leaders and senior managers and limited staff involvement, bias, lack of comparison, limited setting, and issues in generalizability/transferability of results from prospects perspective. Nevertheless, the limitations identified are potentially manageable and can be contextually resolved depending on the nature of the study. Furthermore, PD has been successfully employed in healthcare service and quality improvement programs including in increasing surgical care quality, hand hygiene practice, and reducing healthcare-associated infections. Conclusion The scoping review findings have indicated that healthcare systems have been able to enhance quality, reduce errors, and improve patient outcomes by identifying lessons from those who exhibit exceptional practices and implementing successful strategies in their practice. All the outcomes of PD-based research, however, are dependent on the first step of identifying true PDs. Hence, it is critical that PDs are identified using objective and validated measures of performance as failure to identify true PDs can subsequently lead to failure in identifying best practices for learning and dissemination to other contextually similar settings.

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Section: Resultsmentioning

confidence: 99%

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

Kassie,

Eakin,

Abate

et al. 2024

BMC Health Serv Res

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“…This implies a prospective use of these data for the future co-design, coinnovation, or codelivery of services [ 11 , 12 , 46 ]. Benchmarking of these data provides suitable feedback for professionals to enable improvement and reputational mechanisms [ 47 , 48 ], as well as identifying the good performers and the good practices to be disseminated [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Value of Including the Children’s Experience for Improving Their Rights During Hospitalization: Protocol for the VoiCEs Project

Rosis¹,

Bonciani²,

Spataro³

et al. 2023

JMIR Res Protoc

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Background Users’ feedback is a key asset for organizations that want to improve their services. Studying how organizations are enabling their users to participate in evaluation activities is particularly important, especially when there are vulnerable or disadvantaged people, and the services to be evaluated can be life-changing. This is the case in the coassessment by pediatric patients experiencing hospital stay. The international literature reports a few attempts and several challenges in systematically collecting and using the pediatric patient experience with respect to hospitalization, to undertake quality improvement actions. Objective This paper describes the research protocol of a European project intended to develop and implement a systematic pediatric patient-reported experience measures (PREMs) observatory that will be shared by 4 European children’s hospitals in Finland, Italy, Latvia, and the Netherlands. Methods The VoiCEs (Value of including the Children’s Experience for improving their rightS during hospitalization) project uses a participatory action research approach, based on a mixture of qualitative and quantitative methods. It consists of 6 different phases, including a literature review, an analysis of the previous experiences of pediatric PREMs reported by project partners, a Delphi process, a cycle of focus groups or in-depth interviews with children and their caregivers, a series of workshops with interactive working groups, and a cross-sectional observational survey. The project guarantees the direct participation of children and adolescents in the development and implementation phases of the project. Results The expected results are (1) a deeper knowledge of published methodologies and tools on collecting and reporting pediatric patients’ voice; (2) lessons learnt from the analysis of previous experiences of pediatric PREMs; a consensus reached through a participatory process (3) among experts, (4) pediatric patients and caregivers about a standard set of measures for the evaluation of hospitalization by patients; (5) the implementation of a European observatory on pediatric PREMs; and (6) the collection and comparative reporting of the pediatric patients’ voice. In addition, the project is aimed at studying and proposing innovative methodologies and tools for capturing the pediatric patients’ feedback directly, avoiding the intermediation of parents/guardians. Conclusions Over the last decade, the collection and use of PREMs have gained importance as a research field. Children and adolescents’ perspectives have also been increasingly taken into consideration. However, to date, there are limited experiences regarding the continuous and systematic collection and use of pediatric PREMs data for implementing timely improvement actions. In this perspective, the VoiCEs project provides room for innovation, by contributing to the creation of an international, continuous, and systematic pediatric PREMs observatory that can be joined by other children’s hospitals or hospitals with pediatric patients, and foresees the return of usable and actionable data in benchmarking. International Registered Report Identifier (IRRID) DERR1-10.2196/42804

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“…Furthermore, the results show a very limited number of studies on the relationship between benchmarking and quality improvement, despite the growing interest and research on this topic at the international level. Many articles focus on the practical actions to foster benchmarking as a tool to learn from excellence [ 62 ], set strategic planning [ 40 , 63 ], and improve reputation by naming and faming and peer learning [ 26 ]. However, these articles provide specific frameworks on the use of benchmarking rather than report results and impacts of its application.…”

Section: Discussionmentioning

confidence: 99%

The contribution of benchmarking to quality improvement in healthcare. A systematic literature review

Willmington

Belardi

Murante

et al. 2022

BMC Health Serv Res

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Background Benchmarking has been recognised as a valuable method to help identify strengths and weaknesses at all levels of the healthcare system. Despite a growing interest in the practice and study of benchmarking, its contribution to quality of care have not been well elucidated. As such, we conducted a systematic literature review with the aim of synthesizing the evidence regarding the relationship between benchmarking and quality improvement. We also sought to provide evidence on the associated strategies that can be used to further stimulate quality improvement. Methods We searched three databases (PubMed, Web of Science and Scopus) for articles studying the impact of benchmarking on quality of care (processes and outcomes). Following assessment of the articles for inclusion, we conducted data analysis, quality assessment and critical synthesis according to the PRISMA guidelines for systematic literature review. Results A total of 17 articles were identified. All studies reported a positive association between the use of benchmarking and quality improvement in terms of processes (N = 10), outcomes (N = 13) or both (N = 7). In the majority of studies (N = 12), at least one intervention, complementary to benchmarking, was undertaken to stimulate quality improvement. The interventions ranged from meetings between participants to quality improvement plans and financial incentives. A combination of multiple interventions was present in over half of the studies (N = 10). Conclusions The results generated from this review suggest that the practice of benchmarking in healthcare is a growing field, and more research is needed to better understand its effects on quality improvement. Furthermore, our findings indicate that benchmarking may stimulate quality improvement, and that interventions, complementary to benchmarking, seem to reinforce this improvement. Although this study points towards the benefit of combining performance measurement with interventions in terms of quality, future research should further analyse the impact of these interventions individually.

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Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway

Cited by 7 publications

References 27 publications

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

The use of positive deviance approach to improve health service delivery and quality of care: a scoping review

Value of Including the Children’s Experience for Improving Their Rights During Hospitalization: Protocol for the VoiCEs Project

The contribution of benchmarking to quality improvement in healthcare. A systematic literature review

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