Using the Quadruple Aim Framework to Measure Impact of Heath Technology Implementation: A Case Study of eConsult

Liddy, Clare; Keely, Erin

doi:10.3122/jabfm.2018.03.170397

Cited by 37 publications

(33 citation statements)

References 32 publications

(31 reference statements)

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“…In a study analyzing eConsult's impact using numerous metrics, we examined responses to these questions from 10,364 cases, and found that PCPs ranked eConsult as having high or very high educational value in 92% of cases. 26 PCPs were likewise supportive of incorporating eConsult answers into CME events, with 57% agreeing and only 8% disagreeing. 26 Such responses lend credence to our conclusions, as they demonstrate an appetite for eConsult as an educational tool across a significant wealth of data.…”

Section: Discussionmentioning

confidence: 90%

“…26 PCPs were likewise supportive of incorporating eConsult answers into CME events, with 57% agreeing and only 8% disagreeing. 26 Such responses lend credence to our conclusions, as they demonstrate an appetite for eConsult as an educational tool across a significant wealth of data. Furthermore, other electronic communication platforms have shown similar findings.…”

Section: Discussionmentioning

confidence: 90%

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eConsults and Learning Between Primary Care Providers and Specialists

Liddy

Abu-Hijleh

Joschko

et al. 2019

Fam Med

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Background and Objectives: Patients in many countries face poor access to specialist care. Electronic consultation (eConsult) improves access by allowing primary care providers (PCPs) and specialists to communicate electronically. As more countries adopt eConsult services, there has been growing interest in leveraging them as educational tools. Our study aimed to assess PCPs’ perspectives on eConsult’s ability to improve collegiality between providers and serve as an educational tool. Methods: We conducted a qualitative content analysis of free-text comments left by PCPs using the Champlain BASE eConsult service based in Eastern Ontario, Canada. All responses provided between January 1, 2015 and January 31, 2017 that mentioned education or collegiality were included. Results: PCPs completed 16,712 closeout surveys during the study period, of which 3,601 (22%) included free-text comments. Of these, 223 (6%) included references to education or collegiality. Three prominent themes emerged from the data: building provider relationships, teaching incorporated into answer, and prompting further learning. Conclusions: PCPs described eConsult’s ability to foster stronger relationships with specialists, deliver responses that provided teaching in multiple areas of their practice, and support further learning that extended beyond the case at hand and into their overall practice. The Champlain BASE eConsult service has educational value for providers. Further study is underway to explore how questions and replies submitted through eConsult can be used to facilitate reflective learning and promote feedback to providers.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 90%

eConsults and Learning Between Primary Care Providers and Specialists

Liddy

Abu-Hijleh

Joschko

et al. 2019

Fam Med

Self Cite

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“…Thus, the Triple Aim has expanded to become the Quadruple Aim with the inclusion of a focus on improving the work life of healthcare providers and staff (Bodenheimer & Sinsky, ; Ruddy, Thomas‐Hemak, & Meede, ; Sikka, Morath, & Leape, ). These overarching strategies are used to frame healthcare policy in the United States and internationally (e.g., in Canada; Liddy & Keely, ; and Australia; Productivity Commission, ).…”

Section: Introductionmentioning

confidence: 99%

Impact of a Hospital Evidence‐Based Practice Center (EPC) on Nursing Policy and Practice

Lavenberg

Cacchione

Jayakumar

et al. 2019

Worldviews Ev Based Nurs

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Background: In 2006, our healthcare system created a hospital Evidence-based Practice Center (EPC) to support the local delivery of high-quality, safe and high value patient care. Since then, the importance of healthcare staff work life has also been highlighted, and together these four elements form the Quadruple Aim framework. Synergistic to this Aim, the Magnet ® program promotes and recognizes organizational nursing excellence.Objective: To examine the EPC's work to inform nursing policy and practice in support of the goals of the Quadruple Aim framework and Magnet ® designation.Methods: Methods used included the following: (1) descriptive analysis of the hospital EPC's database of rapid reviews; and (2) administration of a 40-item electronic questionnaire to nurses who requested an EPC review during fiscal years (FY) 2015 and 2016.Results: Of 308 rapid reviews completed in the EPC's first 10 years, 59 (19%) addressed nursing topics. The proportion of reviews relevant to nursing increased from 5% (2/39) in the center's first 2 years to 44% (25/60) in FY 2015-2016. The majority of nursing reviews (39/59) examined processes of care. Of 23 nurses eligible to participate in the survey, 21 responded (91%). Nurses with administrative or managerial responsibilities requested 70% of reviews; clinical nurse specialists and bedside nurses requested 17% and 9%, respectively. Reviews were used to support clinical program development (48%), provide clinical guidance (33%), update nursing policies or procedures (24%) and develop training and curricula (24%). Nurses were satisfied with the hospital EPC reviews (mean; 4.7/5), and 95% indicated they were likely to request a future review.Linking Evidence to Action: A dedicated hospital EPC in partnership with nursing offers a unique mechanism for promoting a culture of evidence-based practice. Nurses at all organizational levels use the services of a hospital EPC to inform nursing policy and practice and are highly satisfied with the process, supporting the Quadruple Aim and Magnet ® designation.

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“…Liddy et al 33 applied the Quadruple Aim Framework to evaluate the impact of a health technology innovation (eConsult). This case study demonstrates the eConsult's impact on patient experience, provider satisfaction, and reducing costs.…”

Section: Applying New Theories and Implementation Science To Transformentioning

confidence: 99%

Advancing the Science of Implementation in Primary Health Care

Bazemore¹,

Neale²,

Lupo³

et al. 2018

J Am Board Fam Med

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Implementation Science is commonly described as the study of methods and approaches that promote the uptake and use of evidence-based interventions into routine practice and policymaking. In this issue of JABFM, investigators share a wealth of new insights from the frontlines of Implementation Science in primary care: what it is, how we are doing it, and how it is advancing the evidence base of primary care. The breadth of implementation science in primary care is affirmed by the range of topics covered, from thought leader recommendations on future directions for the field, to reports on how best practices in policy and practice are shaping primary care implementation in the United States and Canada. There are also important updates on agents of primary care implementation themselves, such as practice facilitators, geriatric care teams, and family physicians interested in providing obstetric care. Other articles report on novel practice transformation efforts that advance health promotion and disease prevention, and innovative approaches to identifying and addressing social determinants of health in primary care practices and the communities they serve. The articles seem to generate as many new questions as they answer, and highlight the need for continued emphasis on advancing the science of implementation in primary health care. (J Am Board Fam Med 2018;31:307-311.)It is commonly estimated that evidence-based interventions require an average of 17 years to be incorporated into routine practice.1,2 Increasing payer and delivery system interest in narrowing that time gap has rapidly elevated the field of Implementation Science; the study of how evidence-based practice and policy can be effectively communicated, deployed, and brought to scale. Effective and efficient implementation is of particular importance in primary care, which is both the largest delivery platform and niche in the US health care ecology and an area largely neglected in the landscape of health care spending and biomedical research. 3,4 This theme issue of JABFM highlights lessons from, and efforts to advance implementation science in primary care.

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Using the Quadruple Aim Framework to Measure Impact of Heath Technology Implementation: A Case Study of eConsult

Cited by 37 publications

References 32 publications

eConsults and Learning Between Primary Care Providers and Specialists

eConsults and Learning Between Primary Care Providers and Specialists

Impact of a Hospital Evidence‐Based Practice Center (EPC) on Nursing Policy and Practice

Advancing the Science of Implementation in Primary Health Care

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