41
IRUS Total
Downloads
  Altmetric

How to study improvement interventions: a brief overview of possible study types

File Description SizeFormat 
325.full.pdfPublished version537.24 kBAdobe PDFView/Open
Title: How to study improvement interventions: a brief overview of possible study types
Authors: Portela, MC
Pronovost, PJ
Woodcock, T
Carter, P
Dixon-Woods, M
Item Type: Journal Article
Abstract: Improvement (defined broadly as purposive efforts to secure positive change) has become an increasingly important activity and field of inquiry within healthcare. This article offers an overview of possible methods for the study of improvement interventions. The choice of available designs is wide, but debates continue about how far improvement efforts can be simultaneously practical (aimed at producing change) and scientific (aimed at producing new knowledge), and whether the distinction between the practical and the scientific is a real and useful one. Quality improvement projects tend to be applied and, in some senses, self-evaluating. They are not necessarily directed at generating new knowledge, but reports of such projects if well conducted and cautious in their inferences may be of considerable value. They can be distinguished heuristically from research studies, which are motivated by and set out explicitly to test a hypothesis, or otherwise generate new knowledge, and from formal evaluations of improvement projects. We discuss variants of trial designs, quasi-experimental designs, systematic reviews, programme evaluations, process evaluations, qualitative studies, and economic evaluations. We note that designs that are better suited to the evaluation of clearly defined and static interventions may be adopted without giving sufficient attention to the challenges associated with the dynamic nature of improvement interventions and their interactions with contextual factors. Reconciling pragmatism and research rigour is highly desirable in the study of improvement. Trade-offs need to be made wisely, taking into account the objectives involved and inferences to be made.
Issue Date: 1-May-2015
Date of Acceptance: 16-Feb-2015
URI: http://hdl.handle.net/10044/1/54021
DOI: https://dx.doi.org/10.1136/bmjqs-2014-003620
ISSN: 2044-5415
Publisher: BMJ Publishing Group
Start Page: 325
End Page: 336
Journal / Book Title: BMJ Quality and Safety
Volume: 24
Issue: 5
Copyright Statement: © 2015 The Author(s). This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Health Policy & Services
THEORETICAL DOMAINS FRAMEWORK
STATISTICAL PROCESS-CONTROL
BEHAVIOR-CHANGE INTERVENTIONS
RANDOMIZED CONTROLLED-TRIAL
HEALTH-CARE IMPROVEMENT
QUALITY-IMPROVEMENT
PATIENT SAFETY
PARIHS FRAMEWORK
IMPLEMENTATION STRATEGIES
ORGANIZATIONAL READINESS
Evaluation methodology
Health services research
Quality improvement methodologies
Social sciences
Statistical process control
Humans
Outcome and Process Assessment (Health Care)
Quality Improvement
Research Design
Publication Status: Published
Open Access location: http://dx.doi.org/10.1136/bmjqs-2014-003620
Appears in Collections:School of Public Health