Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal

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Title: Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal
Author(s): Reed, JE
Issen, L
Woodcock, T
Lennox, L
McNicholas, C
Item Type: Journal Article
Abstract: Background: Despite criticisms that many Quality Improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of, scoring criteria to evaluate programme theory diagrams. Methods: Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. 63 programme theory diagrams (42 driver diagrams and 21 action effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams. Results: Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause/effect relationships, evidence, and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; Action-Effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over Driver Diagrams; no significant differences were observed based on the setting in which Driver Diagrams were developed. Conclusions: The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams, and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.
Publication Date: 9-Apr-2018
Date of Acceptance: 27-Feb-2018
URI: http://hdl.handle.net/10044/1/57934
ISSN: 1353-4505
Publisher: Oxford University Press (OUP)
Journal / Book Title: International Journal for Quality in Health Care
Sponsor/Funder: Chelsea & Westminster Hospital NHS Foundation Trust
The Health Foundation
Funder's Grant Number: N/A
6595
Keywords: 11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Health Policy & Services
Publication Status: Accepted
Embargo Date: publication subject to indefinite embargo
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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