Evidence map›Paper›PMID 28521750›Full record

ArticleImplementation science : IS2017

Data for Improvement and Clinical Excellence: a report of an interrupted time series trial of feedback in home care.

Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic

Abstract read
In one paragraph

Article in Implementation science : IS, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kimberly D FraserFaculty of Nursing, Level 3 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada. kdfraser@ualberta.ca.
Anne E SalesCentre for Clinical Management Research, VA Ann Arbor Healthcare System, 2215 Fuller Road, PO Box 130170, Ann Arbor, MI, 48113, USA.
Melba Andrea B BaylonFaculty of Nursing, Level 3 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
Corinne SchalmAlberta Health and Wellness, 10025 Jasper Ave NW, Edmonton, AB, T5J 1S6, Canada.
John J MiklavcicFaculty of Nursing, Level 3 Edmonton Clinic Health Academy, University of Alberta, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits.

methodsA 10-month audit with feedback intervention study was conducted with care providers in seven home care offices in Alberta, Canada, which involved delivery of four quarterly feedback reports consisting of data derived from the Resident Assessment Instrument - Home Care (RAI-HC). The primary evaluation employed an interrupted time series design using segmented regression analysis to assess the effects of feedback reporting on the four quality indicators: pain, falls, delirium, and hospitalization. Changes in level and trend of the quality indicators were measured before, during, and after the implementation of feedback reports. Pressure ulcer reporting was analyzed as a comparator condition not included in the feedback report. Care providers were surveyed on responses to feedback reporting which informed a process evaluation.

resultsAt initiation of feedback report implementation, the percentage of clients reporting pain and falls significantly increased. Though the percentage of clients reporting pain and falls tended to increase and reporting of delirium and hospital visits tended to decrease relative to the pre-intervention period, there was no significant effect of feedback reporting on quality indicators during the 10-month intervention. The percentage of clients reporting falls, delirium, and hospital visits significantly increased in the 6-month period following feedback reporting relative to the intervention period. About 50% of the care providers that read and understand the feedback reports found the reports useful to make changes to the way clients are cared for.

conclusionsRoutinely collected data used over time for feedback is feasible in home care settings. A high proportion of care providers find feedback reports useful for informing how they care for clients. Since reporting on the frequency of quality indicators increased in the post-intervention period, this study suggests that ongoing use of audit with feedback to enhance health outcomes in home care may promote improved reporting on standardized instruments.

Indexed as

AgedAged, 80 and overAlbertaClinical CompetenceFemaleHome Care ServicesHumansInterrupted Time Series AnalysisLong-Term CareMaleMiddle AgedQuality ImprovementQuality of Health CareSurveys and QuestionnairesAudit with feedback interventionHome careInterrupted time seriesProcess evaluationQuality improvement

Identifiers

PMID28521750
PMCPMC5437696

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.