Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities

Meehan, Thomas P.; Qazi, Daniel J.; Hoof, Thomas J. Van; Ng, Beng Koon; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle M.; Johnson, Florence; Quetti, Deborah

doi:10.1016/j.jamda.2015.02.015

Cited by 18 publications

(36 citation statements)

References 14 publications

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“…Therefore, hospitals and physicians must institute strategies aimed at improved patient education, predischarge planning, and outpatient follow‐up. Multiple studies have demonstrated the efficacy of various coordinated programs that reinforce these principles . Project Re‐Engineered Discharge (RED) coordinates telephone calls between pharmacists and patients 2‐4 days after discharge in order to answer questions and avoid medication‐related problems .…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies have demonstrated the efficacy of various coordinated programs that reinforce these principles. [50][51][52] Project Re-Engineered Discharge (RED) coordinates telephone calls between pharmacists and patients 2-4 days after discharge in order to answer questions and avoid medication-related problems. 51 Project Better Outcomes by Optimizing Safe Transitions (BOOST) focuses on strategies, including improved patient education, reduction of polypharmacy, and verification of outpatient follow-up.…”

Section: Consequence Of 30-day Returns To the Emergency Department/mentioning

confidence: 99%

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Predictors of returns to the emergency department after head and neck surgery

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Section: Consequence Of 30-day Returns To the Emergency Department/mentioning

confidence: 99%

Predictors of returns to the emergency department after head and neck surgery

et al. 2017

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“…In practical terms, this involved actively engaging frontline staff and other stakeholders and encouraging participation or co-design [39,43,45,46,54], assessing and/or developing capacity and capability in clinical microsystems [42,46,52,57] and addressing organisational readiness prior to implementation [54,66]. In some studies, teams utilised QI methods as tools to help them understand and analyse the complexity of their systems [59], whereas others used specific frameworks to systematically evaluate their local context and identify relevant contextual factors to address, e.g. the context curriculum developed using MUSIQ, which facilitated teams' use of QI methodology to address contextual factors to reduce barriers and support implementation [51].…”

Section: Context Assessmentmentioning

confidence: 99%

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

et al. 2020

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Background: Recognising the influence of context and the context-sensitive nature of quality improvement (QI) interventions is crucial to implementing effective improvements and successfully replicating them in new settings, yet context is still poorly understood. To address this challenge, it is necessary to capture generalisable knowledge, first to understand which aspects of context are most important to QI and why, and secondly, to explore how these factors can be managed to support healthcare improvement, in terms of implementing successful improvement initiatives, achieving sustainability and scaling interventions. The research question was how and why does context influence quality improvement initiatives in healthcare? Methods: A realist review explored the contextual conditions that influence healthcare improvement. Realist methodology integrates theoretical understanding and stakeholder input with empirical research findings. The review aimed to identify and understand the role of context during the improvement cycle, i.e. planning, implementation, sustainability and transferability; and distil new knowledge to inform the design and development of context-sensitive QI initiatives. We developed a preliminary theory of the influence of context to arrive at a conceptual and theoretical framework. Results: Thirty-five studies were included in the review, demonstrating the interaction of key contextual factors across healthcare system levels during the improvement cycle. An evidence-based explanatory theoretical model is proposed to illustrate the interaction between contextual factors, system levels (macro, meso, micro) and the stages of the improvement journey. Findings indicate that the consideration of these contextual factors would enhance the design and delivery of improvement initiatives, across a range of improvement settings. Conclusions: This is the first realist review of context in QI and contributes to a deeper understanding of how context influences quality improvement initiatives. The distillation of key contextual factors offers the potential to inform the design and development of context-sensitive interventions to enhance improvement initiatives and address the challenge of spread and sustainability. Future research should explore the application of our conceptual model to enhance improvement-planning processes.

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“…INTERACT training and implementation support were based on experiences with multiple prior educational and quality improvement programs in SNFs using a strategy that a SNF chain, a coalition of SNFs, or a health system and its affiliated SNFs could theoretically emulate and disseminate. [14][15][16][17] Each intervention SNF selected a project champion and co-champion who were responsible for facilitating INTERACT training and implementation, including 2 HUCKFELDT ET AL. 2018 JAGS JAGS SEPTEMBER 2018-VOL.…”

Section: Interventionmentioning

confidence: 99%

Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations

Huckfeldt

Kane

Yang

et al. 2018

J American Geriatrics Society

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Increased reported use of core INTERACT tools was associated with significantly greater reductions in all-cause hospitalizations and PAHs in both intervention and control SNFs, suggesting that motivation and incentives to reduce hospitalizations were more important than the training and support provided in the trial in improving outcomes. Further research is needed to better understand the most effective strategies to motivate SNFs to implement and sustain quality improvement programs such as INTERACT.

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Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities

Cited by 18 publications

References 14 publications

Predictors of returns to the emergency department after head and neck surgery

Predictors of returns to the emergency department after head and neck surgery

The influence of contextual factors on healthcare quality improvement initiatives: a realist review

Degree of Implementation of the Interventions to Reduce Acute Care Transfers (INTERACT) Quality Improvement Program Associated with Number of Hospitalizations

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