TY - JOUR
T1 - Quality improvement strategies for organizational change
T2 - a multiphase observational study to increase insight into nonparticipating organizations
AU - de Groot, Jeanny J. A.
AU - Timmermans, Maite
AU - Maessen, Jose M. C.
AU - Winkens, Bjorn
AU - Dirksen, Carmen D.
AU - Slangen, Brigitte F. M.
AU - van der Weijden, Trudy
PY - 2018/12/29
Y1 - 2018/12/29
N2 - BackgroundThe scope of implementation research is often restricted to the analysis of organizations that participate voluntarily in implementation interventions. The recruitment of participants for a quality improvement collaborative increases awareness of the specific innovation. The objective of this multiphase observational study was to identify differences between organizations that participated in a large-scale implementation project aiming to improve perioperative care, functional recovery, and length of hospital stay after gynecologic surgery and organizations that did not participate. A secondary objective was to explore how perioperative practice changed among nonparticipants.MethodsOf the seven gynecology departments of nonparticipating Dutch hospitals, five agreed to participate in a retrospective analysis. Baseline data of participating hospitals' (N=19) characteristics, time to functional recovery, and length of hospital stay were compared. Outcome measures for the subsequent pre-post awareness study in the five nonparticipating hospitals were: (1) overall adherence to predefined evidence-based perioperative elements; and (2) change in functional recovery and length of hospital stay. Multivariable regression models, adjusted for baseline characteristics, were used for analysis.ResultsIn retrospect, nonparticipating and participating hospitals did not differ in baseline characteristics, functional recovery, and length of hospital stay. In three of the five nonparticipating hospitals, adherence to the selected evidence-based perioperative elements increased significantly after awareness of the trial (overall mean difference 9.7%, 95% CI 6.9 to 12.5%, p
AB - BackgroundThe scope of implementation research is often restricted to the analysis of organizations that participate voluntarily in implementation interventions. The recruitment of participants for a quality improvement collaborative increases awareness of the specific innovation. The objective of this multiphase observational study was to identify differences between organizations that participated in a large-scale implementation project aiming to improve perioperative care, functional recovery, and length of hospital stay after gynecologic surgery and organizations that did not participate. A secondary objective was to explore how perioperative practice changed among nonparticipants.MethodsOf the seven gynecology departments of nonparticipating Dutch hospitals, five agreed to participate in a retrospective analysis. Baseline data of participating hospitals' (N=19) characteristics, time to functional recovery, and length of hospital stay were compared. Outcome measures for the subsequent pre-post awareness study in the five nonparticipating hospitals were: (1) overall adherence to predefined evidence-based perioperative elements; and (2) change in functional recovery and length of hospital stay. Multivariable regression models, adjusted for baseline characteristics, were used for analysis.ResultsIn retrospect, nonparticipating and participating hospitals did not differ in baseline characteristics, functional recovery, and length of hospital stay. In three of the five nonparticipating hospitals, adherence to the selected evidence-based perioperative elements increased significantly after awareness of the trial (overall mean difference 9.7%, 95% CI 6.9 to 12.5%, p
KW - Implementation
KW - Nonparticipant analysis
KW - Awareness
KW - Length of stay
KW - Perioperative care
KW - ENHANCED RECOVERY PATHWAYS
KW - ERAS(R) SOCIETY RECOMMENDATIONS
KW - SURGERY
KW - IMPLEMENTATION
KW - GUIDELINES
KW - PROGRAMS
KW - IMPACT
KW - CARE
U2 - 10.1186/s12913-018-3847-6
DO - 10.1186/s12913-018-3847-6
M3 - Article
C2 - 30594194
SN - 1472-6963
VL - 18
JO - BMC Health Services Research
JF - BMC Health Services Research
M1 - 1011
ER -