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    How, in what contexts, and why do quality dashboards lead to improvements in care quality in acute hospitals? Protocol for a realist feasibility evaluation

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    randell_et_al_2020.pdf (805.7Kb)
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    Publication date
    2020-02-25
    Author
    Randell, Rebecca
    Alvarado, Natasha
    McVey, Lynn
    Greenhalgh, J.
    West, R.M.
    Farrin, A.
    Gale, C.
    Parslow, R.
    Keen, J.
    Elshehaly, Mai
    Ruddle, R.A.
    Lake, J.
    Mamas, M.
    Feltbower, R.
    Dowding, D.
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    Keyword
    Audit
    Clinical audit
    Health informatics
    Informatics
    Qualitative research
    Quality in health care
    Rights
    (c) 2020 The Authors. This is an Open Access article distributed under the Creative Commons CC-BY license (https://creativecommons.org/licenses/by/4.0/)
    Peer-Reviewed
    Yes
    
    Metadata
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    Abstract
    National audits are used to monitor care quality and safety and are anticipated to reduce unexplained variations in quality by stimulating quality improvement (QI). However, variation within and between providers in the extent of engagement with national audits means that the potential for national audit data to inform QI is not being realised. This study will undertake a feasibility evaluation of QualDash, a quality dashboard designed to support clinical teams and managers to explore data from two national audits, the Myocardial Ischaemia National Audit Project (MINAP) and the Paediatric Intensive Care Audit Network (PICANet). Realist evaluation, which involves building, testing and refining theories of how an intervention works, provides an overall framework for this feasibility study. Realist hypotheses that describe how, in what contexts, and why QualDash is expected to provide benefit will be tested across five hospitals. A controlled interrupted time series analysis, using key MINAP and PICANet measures, will provide preliminary evidence of the impact of QualDash, while ethnographic observations and interviews over 12 months will provide initial insight into contexts and mechanisms that lead to those impacts. Feasibility outcomes include the extent to which MINAP and PICANet data are used, data completeness in the audits, and the extent to which participants perceive QualDash to be useful and express the intention to continue using it after the study period. The study has been approved by the University of Leeds School of Healthcare Research Ethics Committee. Study results will provide an initial understanding of how, in what contexts, and why quality dashboards lead to improvements in care quality. These will be disseminated to academic audiences, study participants, hospital IT departments and national audits. If the results show a trial is feasible, we will disseminate the QualDash software through a stepped wedge cluster randomised trial.
    URI
    http://hdl.handle.net/10454/17759
    Version
    Published version
    Citation
    Randell R, Alvarado N, McVey L et al (2020) How, in what contexts, and why do quality dashboards lead to improvements in care quality in acute hospitals? Protocol for a realist feasibility evaluation. BMJ Open. 10(2): e033208.
    Link to publisher’s version
    https://doi.org/10.1136/bmjopen-2019-033208
    Type
    Article
    Collections
    Engineering and Informatics Publications
    Health Studies Publications

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