ReviewBMC health services research2015
The influence of context on the effectiveness of hospital quality improvement strategies: a review of systematic reviews.
Review in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- Effectiveness of quality improvement interventions in improving cardiovascular disease-related outcomes in primary and tertiary care: A systematic review and meta-analyses.BMC primary care · 2025Pooled it
- Does WASH FIT Improve Water, Sanitation, and Hygiene and Related Health Impacts in Healthcare Facilities? A Systematic Review.International journal of environmental research and public health · 2025Pooled it
- The utility of website-based quality improvement tools for health professionals: a systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2024Pooled it
- Hospital accreditation: an umbrella review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2023Pooled it
- Hospital contextual factors affecting the implementation of health technologies: a systematic review.BMC health services research · 2021Pooled it
- How and under what circumstances do quality improvement collaboratives lead to better outcomes? A systematic review.Implementation science : IS · 2020Pooled it
- Healthcare Professional's Perception of Patient Safety Measured by the Hospital Survey on Patient Safety Culture: A Systematic Review and Meta-Analysis.TheScientificWorldJournal · 2018Pooled it
- Pooled it
- Clinical trials registries are underused in the pregnancy and childbirth literature: a systematic review of the top 20 journals.BMC research notes · 2016Pooled it
- How Well Is Quality Improvement Described in the Perioperative Care Literature? A Systematic Review.Joint Commission journal on quality and patient safety · 2016Pooled it
- Development and Formative Assessment of an Innovative Blended Educational Course for Care of Small and Sick Neonates in India and SEARO Countries.Indian pediatrics · 2026Article
- Determinants of sustainable quality improvement for operating room clean air systems: a two-phase sequential qualitative study in Dutch hospitals.BMC health services research · 2026Article
- Assessing the association between the domains of the Atlas Context Assessment and implementation outcomes of the TeamBirth project: a cross-sectional study.BMC health services research · 2026Article
- Understanding the development and implementation of national quality of care and patient safety strategic documents: a scoping review.BMC health services research · 2025Article
- Making the "Birthing-Friendly" hospital designation better.Health affairs scholar · 2025Article
- Using FRAM visualisations in quality improvement projects: identifying and testing strategies to improve anticoagulant use in the perioperative process.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2025Article
- Factors associated with successful implementation of Clean Cut: a perioperative surgical site infection prevention quality improvement programme-a cohort study of low-resource hospitals.BMJ global health · 2025Article
- Characteristics of Quality Improvement Projects in Health Services: A Systematic Scoping Review.Journal of evidence-based medicine · 2025Article
- Organizational characteristics associated with sustained participation in internal quality improvement: Findings from two waves of a national sample of physician practices in the United States.Social science & medicine (1982) · 2025Article
- Integrating Quality Improvement: A Qualitative Study of Leadership Approaches in Healthcare Services in Norwegian Municipalities.Health services insights · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is now widely accepted that the mixed effect and success rates of strategies to improve quality and safety in health care are in part due to the different contexts in which the interventions are planned and implemented. The objectives of this study were to (i) describe the reporting of contextual factors in the literature on the effectiveness of quality improvement strategies, (ii) assess the relationship between effectiveness and contextual factors, and (iii) analyse the importance of contextual factors.
methodsWe conducted an umbrella review of systematic reviews searching the following databases: PubMed, Cochrane Database of Systematic Reviews, Embase and CINAHL. The search focused on quality improvement strategies included in the Cochrane Effective Practice and Organisation of Care Group taxonomy. We extracted data on quality improvement effectiveness and context factors. The latter were categorized according to the Model for Understanding Success in Quality tool.
resultsWe included 56 systematic reviews in this study of which only 35 described contextual factors related with the effectiveness of quality improvement interventions. The most frequently reported contextual factors were: quality improvement team (n = 12), quality improvement support and capacity (n = 11), organization (n = 9), micro-system (n = 8), and external environment (n = 4). Overall, context factors were poorly reported. Where they were reported, they seem to explain differences in quality improvement effectiveness; however, publication bias may contribute to the observed differences.
conclusionsContextual factors may influence the effectiveness of quality improvement interventions, in particular at the level of the clinical micro-system. Future research on the implementation and effectiveness of quality improvement interventions should emphasize formative evaluation to elicit information on context factors and report on them in a more systematic way in order to better appreciate their relative importance.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.