ArticleBMJ quality & safety2017
Combining qualitative and quantitative operational research methods to inform quality improvement in pathways that span multiple settings.
Article in BMJ quality & safety, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Commonality of 25 component themes of integrated care for children: rapid review of 170 models.BMC health services research · 2025Pooled it
- A mixed methods approach for the identification and assessment of workforce innovations in home health care.Frontiers in health services · 2026Article
- Optimising Paediatric Transition to Intensive Care for Adults (OPTICAL): study protocol for a mixed method study.BMJ open · 2025Article
- Understanding and measuring workplace violence in healthcare: a Canadian systematic framework to address a global healthcare phenomenon.BMC emergency medicine · 2025Article
- Leveraging quality improvement initiatives to support development of decision support tools in healthcare.Health systems (Basingstoke, England) · 2025Article
- Learning to See: Using Mixed OR Methods to Model Radiology Staff Workload and Support Decision Making in CT.SN computer science · 2022Article
- Expected Scopes of Health Emergency and Disaster Risk Management (Health EDRM): Report on the Expert Workshop at the Annual Conference for the Japanese Association for Disaster Medicine 2020.International journal of environmental research and public health · 2021Article
- Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study.Implementation science : IS · 2021Article
- Using a 'rich picture' to facilitate systems thinking in research coproduction.Health research policy and systems · 2020Article
- Exploring the usefulness of Lexis diagrams for quality improvement.BMC medical informatics and decision making · 2020Article
- Re-energising the way we manage change in healthcare: the case for soft systems methodology and its application to evidence-based practice.BMC health services research · 2019Article
- Anaesthetic research in low- and middle-income countries.Anaesthesia · 2019Article
- Article
- Improving the production of applied health research findings: insights from a qualitative study of operational research.Implementation science : IS · 2017Article
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 at 2 institutions in 1 country.
Funding
Abstract
backgroundImproving integration and continuity of care across sectors within resource constraints is a priority in many health systems. Qualitative operational research methods of problem structuring have been used to address quality improvement in services involving multiple sectors but not in combination with quantitative operational research methods that enable targeting of interventions according to patient risk. We aimed to combine these methods to augment and inform an improvement initiative concerning infants with congenital heart disease (CHD) whose complex care pathway spans multiple sectors.
methodsSoft systems methodology was used to consider systematically changes to services from the perspectives of community, primary, secondary and tertiary care professionals and a patient group, incorporating relevant evidence. Classification and regression tree (CART) analysis of national audit datasets was conducted along with data visualisation designed to inform service improvement within the context of limited resources.
resultsA 'Rich Picture' was developed capturing the main features of services for infants with CHD pertinent to service improvement. This was used, along with a graphical summary of the CART analysis, to guide discussions about targeting interventions at specific patient risk groups. Agreement was reached across representatives of relevant health professions and patients on a coherent set of targeted recommendations for quality improvement. These fed into national decisions about service provision and commissioning.
conclusionsWhen tackling complex problems in service provision across multiple settings, it is important to acknowledge and work with multiple perspectives systematically and to consider targeting service improvements in response to confined resources. Our research demonstrates that applying a combination of qualitative and quantitative operational research methods is one approach to doing so that warrants further consideration.
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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.