Livingood WC, Bilello L, Lukens-Bull K. Seeing the quality improvement forest through the quality improvement trees: A meta-synthesis of case studies in Florida and Georgia.
SAGE Open Med 2019;
7:2050312119845703. [PMID:
31041099 PMCID:
PMC6477764 DOI:
10.1177/2050312119845703]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/02/2019] [Indexed: 11/16/2022] Open
Abstract
Objectives
To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices.
Methods
A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria. The primary focus of the analysis and synthesis were the reported processes and findings that included responses to structured questioning in addition to emergent results from direct observation and semi-structured open-ended interviewing.
Results
The key insights for the use of quality improvement in public health and healthcare settings included (1) the essential importance of data monitoring, analysis, and data-based decision making; (2) the need to focus on internal mutable factors within organizations; (3) the critical role of quality improvement team group dynamics; (4) the value of using a quality improvement collaborative or multi-clinic quality council/committee for sharing and comparing performance on key metrics; and (5) the need to identify a quality improvement approach and methods for clarification as a structured quality improvement intervention.
Conclusion
In addition to the advantages of using quality improvement to enhance or improve healthcare and public health services, there is also potential for quality improvement to serve as a model for enhancing the adoption of evidence-based practices within the context of dissemination and implementation research.
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