Evidence map›Paper›PMID 30594194›Full record

Observational studyBMC health services research2018

Quality improvement strategies for organizational change: a multiphase observational study to increase insight into nonparticipating organizations.

Jeanny J A de Groot, Maite Timmermans, José M C Maessen, Bjorn Winkens, Carmen D Dirksen, Brigitte F M Slangen, Trudy van der Weijden

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.3field-weighted citation impact, top 33% of its field
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

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

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

7 authors at 2 institutions in 2 countries.

Jeanny J A de GrootDepartment of Family Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands. jeanny.de.groot@mumc.nl.ORCID http://orcid.org/0000-0002-0000-4752
Maite TimmermansDepartment of Obstetrics and Gynaecology, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
José M C MaessenDepartment of Family Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Bjorn WinkensDepartment of Methodology and Statistics, CAPHRI, School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Carmen D DirksenDepartment of Clinical Epidemiology and Medical Technology Assessment, CAPHRI, School for Public Health and Primary Care, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
Brigitte F M SlangenDepartment of Obstetrics and Gynaecology, Maastricht University Medical Centre, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
Trudy van der WeijdenDepartment of Family Medicine, CAPHRI, School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Maastricht University Medical Centre · NLMaastricht University · NL

Funding

ZonMw 837003002
6 · The paper itself

Abstract

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 <  0.001). Linear regression models revealed no statistically significant or clinically relevant differences in time to functional recovery (mean difference - 0.2 days, 95% CI -0.7 to 0.2, p = 0.319) or length of hospital stay (mean difference - 0.4 days, 95% CI -1.3 to 0.5, p = 0.419) in the nonparticipating hospitals. None of these hospitals managed to reduce time to functional recovery or length of hospital stay significantly.

conclusionsNo differences in perioperative outcomes between the nonparticipating and participating hospitals were identified at baseline. Despite the statistically significant improvement in overall evidence-based perioperative care, the awareness raised by recruitment activities alone was not enough to reduce time to functional recovery and length of hospital stay in nonparticipating hospitals. Insight into the trends of nonparticipants is valuable to existing implementation effectiveness research.

Indexed as

AgedFemaleGynecologic Surgical ProceduresHumansMiddle AgedOrganizational InnovationPerioperative CareQuality ImprovementRecovery of FunctionRetrospective StudiesAwarenessImplementationLength of stayNonparticipant analysisPerioperative care

Identifiers

PMID30594194
PMCPMC6311021
OpenAlexW2908354972

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.