The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery
Abstract Background The concept of value-based healthcare is being used worldwide to improve healthcare. The Intervention Selection Toolbox was developed to bridge the gap of value-based healthcare, between insights in outcomes and actual quality improvement initiatives. In this study we aimed to ev...
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-09264-3 |
| _version_ | 1827970559597608960 |
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| author | Bo Smalbroek Joanna Vijverberg Milad Fahim Lea Dijksman Douwe Biesma Anke Smits Frits van Merode Paul van der Nat |
| author_facet | Bo Smalbroek Joanna Vijverberg Milad Fahim Lea Dijksman Douwe Biesma Anke Smits Frits van Merode Paul van der Nat |
| author_sort | Bo Smalbroek |
| collection | DOAJ |
| description | Abstract Background The concept of value-based healthcare is being used worldwide to improve healthcare. The Intervention Selection Toolbox was developed to bridge the gap of value-based healthcare, between insights in outcomes and actual quality improvement initiatives. In this study we aimed to evaluate the use of the Intervention Selection Toolbox in daily practice of a quality improvement team in a hospital setting. Methods A methodological triangulation design was used. The Intervention Selection Toolbox was used by a multidisciplinary quality improvement team for colorectal cancer care in a large teaching hospital. In-depth semi-structured interviews, focusing on the key elements of process evaluation, were conducted after implementation with representatives of the quality improvement team to evaluate the use of the Intervention Selection Toolbox. Quantitative data regarding improvement initiatives and degree of implementation was also collected. Results The use of the Intervention Selection Toolbox initially resulted in 80 potential quality improvement initiatives. Eventually, two high potential improvement initiatives were selected. Some components of the toolbox were successfully implemented in daily practice, although ‘standard monitoring’ and ‘causal chain analysis’ proved more difficult to implement. Qualitative analysis was performed with ten members of the multidisciplinary team before thematic saturation occurred. Interviewed members had a wide range in characteristics: age 28–61 years, clinical experience 6–38 years and educational attainment from vocational program to academic doctorate. The Interviews showed added value in the use of the toolbox, but identified time and organizational management as restricting factors. Conclusions The Intervention Selection Toolbox is useful to systematically identify improvement initiatives with impact on health outcomes that matter to patients. However, before implementation organizational structure should be optimized to maximize success and efficiency on integration of the Intervention Selection Toolbox. |
| first_indexed | 2024-04-09T18:55:41Z |
| format | Article |
| id | doaj.art-2047d928332a43408869fe090f7476be |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-09T18:55:41Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-2047d928332a43408869fe090f7476be2023-04-09T11:11:35ZengBMCBMC Health Services Research1472-69632023-04-012311910.1186/s12913-023-09264-3The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgeryBo Smalbroek0Joanna Vijverberg1Milad Fahim2Lea Dijksman3Douwe Biesma4Anke Smits5Frits van Merode6Paul van der Nat7Department of Value-Based Healthcare, St. Antonius HospitalDepartment of Value-Based Healthcare, St. Antonius HospitalDepartment of Value-Based Healthcare, St. Antonius HospitalDepartment of Value-Based Healthcare, St. Antonius HospitalDepartment of Internal Medicine, Leiden University Medical CentreDepartment of Surgery, St. Antonius HospitalCare and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre+Department of Value-Based Healthcare, St. Antonius HospitalAbstract Background The concept of value-based healthcare is being used worldwide to improve healthcare. The Intervention Selection Toolbox was developed to bridge the gap of value-based healthcare, between insights in outcomes and actual quality improvement initiatives. In this study we aimed to evaluate the use of the Intervention Selection Toolbox in daily practice of a quality improvement team in a hospital setting. Methods A methodological triangulation design was used. The Intervention Selection Toolbox was used by a multidisciplinary quality improvement team for colorectal cancer care in a large teaching hospital. In-depth semi-structured interviews, focusing on the key elements of process evaluation, were conducted after implementation with representatives of the quality improvement team to evaluate the use of the Intervention Selection Toolbox. Quantitative data regarding improvement initiatives and degree of implementation was also collected. Results The use of the Intervention Selection Toolbox initially resulted in 80 potential quality improvement initiatives. Eventually, two high potential improvement initiatives were selected. Some components of the toolbox were successfully implemented in daily practice, although ‘standard monitoring’ and ‘causal chain analysis’ proved more difficult to implement. Qualitative analysis was performed with ten members of the multidisciplinary team before thematic saturation occurred. Interviewed members had a wide range in characteristics: age 28–61 years, clinical experience 6–38 years and educational attainment from vocational program to academic doctorate. The Interviews showed added value in the use of the toolbox, but identified time and organizational management as restricting factors. Conclusions The Intervention Selection Toolbox is useful to systematically identify improvement initiatives with impact on health outcomes that matter to patients. However, before implementation organizational structure should be optimized to maximize success and efficiency on integration of the Intervention Selection Toolbox.https://doi.org/10.1186/s12913-023-09264-3Value-based healthcareColorectalImprovement interventionsIntervention Selection ToolboxDecision-makingQuality improvement |
| spellingShingle | Bo Smalbroek Joanna Vijverberg Milad Fahim Lea Dijksman Douwe Biesma Anke Smits Frits van Merode Paul van der Nat The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery BMC Health Services Research Value-based healthcare Colorectal Improvement interventions Intervention Selection Toolbox Decision-making Quality improvement |
| title | The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery |
| title_full | The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery |
| title_fullStr | The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery |
| title_full_unstemmed | The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery |
| title_short | The Intervention Selection Toolbox to improve patient-relevant outcomes: an implementation and qualitative evaluation study in colorectal cancer surgery |
| title_sort | intervention selection toolbox to improve patient relevant outcomes an implementation and qualitative evaluation study in colorectal cancer surgery |
| topic | Value-based healthcare Colorectal Improvement interventions Intervention Selection Toolbox Decision-making Quality improvement |
| url | https://doi.org/10.1186/s12913-023-09264-3 |
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