Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study
Abstract Background National audits are a common, but variably effective, intervention to improve services. This study aimed to design an intervention to increase the effectiveness of national audit. Methods We used interviews, documentary analysis, observations, co-design and stakeholder engagement...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-022-01099-9 |
| _version_ | 1811323535788867584 |
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| author | Michael Sykes Elaine O’Halloran Lucy Mahon Jenny McSharry Louise Allan Richard Thomson Tracy Finch Niina Kolehmainen |
| author_facet | Michael Sykes Elaine O’Halloran Lucy Mahon Jenny McSharry Louise Allan Richard Thomson Tracy Finch Niina Kolehmainen |
| author_sort | Michael Sykes |
| collection | DOAJ |
| description | Abstract Background National audits are a common, but variably effective, intervention to improve services. This study aimed to design an intervention to increase the effectiveness of national audit. Methods We used interviews, documentary analysis, observations, co-design and stakeholder engagement methods. The intervention was described in an intervention manual and illustrated using a logic model. Phase 1 described the current hospital response to a national audit. Phase 2 identified potential enhancements. Phase 3 developed a strategy to implement the enhancements. Phase 4 explored the feasibility of the intervention alongside the National Audit of Dementia and refined the intervention. Phase 5 adapted the intervention to a second national audit (National Diabetes Audit). Phase 6 explored the feasibility and fidelity of the intervention alongside the National Diabetes Audit and used the findings to further refine the intervention. Results The developed intervention is a quality improvement collaborative (QIC), containing virtual educational workshop, virtual outreach for local team leads and virtual facilitation of a learning collaborative delivered after feedback has been received. The QIC aims to support national audit recipients to undertake improvement actions tailored to their local context. The target audience is clinical and clinical governance leaders. We found that actions from national audit were constrained by what the clinical lead perceived they deliver personally, these actions were not aligned to identified influences upon performance. We found that the hospital response could be enhanced by targeting low baseline performance, identifying and addressing influences upon to performance, developing trust and credibility, addressing recipient priorities, presenting meaningful comparisons, developing a conceptual model, involving stakeholders and considering the opportunity cost. Phase 3 found that an educational workshop and outreach strategy could support implementation of the enhancements through developing coherence and cognitive participation. We found feasibility could be increased by revising the content, re-naming the intervention, amending activities to address time commitment, incorporating a more structured analysis of influences, supporting collaboration and developing local feedback mechanisms. Phase 5 found adaptation to a second national audit involved reflecting differences in the clinical topic, context and contractual requirements. We found that the behaviour change techniques identified in the manual were delivered by facilitators. Participants reported positive attitudes towards the intervention and that the intervention was appropriate. Conclusions The QIC supports local teams to tailor their actions to local context and develop change commitment. Future work will evaluate the effectiveness of the intervention as an adjunct to the National Diabetes Audit. |
| first_indexed | 2024-04-13T13:56:54Z |
| format | Article |
| id | doaj.art-b55de468c9ec49e08b535a0e2371d6a5 |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-04-13T13:56:54Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-b55de468c9ec49e08b535a0e2371d6a52022-12-22T02:44:10ZengBMCPilot and Feasibility Studies2055-57842022-07-018111810.1186/s40814-022-01099-9Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development studyMichael Sykes0Elaine O’Halloran1Lucy Mahon2Jenny McSharry3Louise Allan4Richard Thomson5Tracy Finch6Niina Kolehmainen7Northumbria UniversitySchool of Psychology, National University of Ireland GalwaySchool of Psychology, National University of Ireland GalwaySchool of Psychology, National University of Ireland GalwayUniversity of Exeter, South Cloisters, St. Luke’s CampusNewcastle UniversityNorthumbria UniversityNewcastle UniversityAbstract Background National audits are a common, but variably effective, intervention to improve services. This study aimed to design an intervention to increase the effectiveness of national audit. Methods We used interviews, documentary analysis, observations, co-design and stakeholder engagement methods. The intervention was described in an intervention manual and illustrated using a logic model. Phase 1 described the current hospital response to a national audit. Phase 2 identified potential enhancements. Phase 3 developed a strategy to implement the enhancements. Phase 4 explored the feasibility of the intervention alongside the National Audit of Dementia and refined the intervention. Phase 5 adapted the intervention to a second national audit (National Diabetes Audit). Phase 6 explored the feasibility and fidelity of the intervention alongside the National Diabetes Audit and used the findings to further refine the intervention. Results The developed intervention is a quality improvement collaborative (QIC), containing virtual educational workshop, virtual outreach for local team leads and virtual facilitation of a learning collaborative delivered after feedback has been received. The QIC aims to support national audit recipients to undertake improvement actions tailored to their local context. The target audience is clinical and clinical governance leaders. We found that actions from national audit were constrained by what the clinical lead perceived they deliver personally, these actions were not aligned to identified influences upon performance. We found that the hospital response could be enhanced by targeting low baseline performance, identifying and addressing influences upon to performance, developing trust and credibility, addressing recipient priorities, presenting meaningful comparisons, developing a conceptual model, involving stakeholders and considering the opportunity cost. Phase 3 found that an educational workshop and outreach strategy could support implementation of the enhancements through developing coherence and cognitive participation. We found feasibility could be increased by revising the content, re-naming the intervention, amending activities to address time commitment, incorporating a more structured analysis of influences, supporting collaboration and developing local feedback mechanisms. Phase 5 found adaptation to a second national audit involved reflecting differences in the clinical topic, context and contractual requirements. We found that the behaviour change techniques identified in the manual were delivered by facilitators. Participants reported positive attitudes towards the intervention and that the intervention was appropriate. Conclusions The QIC supports local teams to tailor their actions to local context and develop change commitment. Future work will evaluate the effectiveness of the intervention as an adjunct to the National Diabetes Audit.https://doi.org/10.1186/s40814-022-01099-9Audit and feedbackQuality improvementIntervention developmentImplementation |
| spellingShingle | Michael Sykes Elaine O’Halloran Lucy Mahon Jenny McSharry Louise Allan Richard Thomson Tracy Finch Niina Kolehmainen Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study Pilot and Feasibility Studies Audit and feedback Quality improvement Intervention development Implementation |
| title | Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study |
| title_full | Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study |
| title_fullStr | Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study |
| title_full_unstemmed | Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study |
| title_short | Enhancing national audit through addressing the quality improvement capabilities of feedback recipients: a multi-phase intervention development study |
| title_sort | enhancing national audit through addressing the quality improvement capabilities of feedback recipients a multi phase intervention development study |
| topic | Audit and feedback Quality improvement Intervention development Implementation |
| url | https://doi.org/10.1186/s40814-022-01099-9 |
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