ArticleBMJ quality & safety2019
Use of a maternal newborn audit and feedback system in Ontario: a collective case study.
Article in BMJ quality & safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2022Pooled it
- Impact of audit and feedback with action implementation toolbox on improving ICU pain management: cluster-randomised controlled trial.BMJ quality & safety · 2019Trial
- Who chooses to engage? Understanding the characteristics of physicians who voluntarily engage with an audit and feedback intervention: a retrospective cohort study.BMJ quality & safety · 2026Article
- Evolving determinants of implementing low-risk childbirth quality improvement in Japan: a longitudinal qualitative study.BMC health services research · 2026Article
- Acceptability of Components for a Mandatory Quality Improvement Framework: A Survey Among Swiss General Practitioners.Health services insights · 2025Article
- Development, Implementation, and Evaluation Methods for Dashboards in Health Care: Scoping Review.JMIR medical informatics · 2024Article
- A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contexts.BMJ open quality · 2024Review
- Planning and implementing practice changes in Ontario maternal-newborn hospital units: a secondary qualitative analysis.BMC pregnancy and childbirth · 2023Article
- Data Resource Profile: Better Outcomes Registry & Network (BORN) Ontario.International journal of epidemiology · 2021Article
- Alignment in implementation of evidence-based interventions: a scoping review.Implementation science : IS · 2021Article
- Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches.BMC medical research methodology · 2021Review
- Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records.Scientific reports · 2020Article
- Obstetrical safety indicators for preventing hospital harms in low risk births: a scoping review protocol.BMJ open · 2020Article
- Data accuracy in the Ontario birth Registry: a chart re-abstraction study.BMC health services research · 2019Article
- Facilitating action planning within audit and feedback interventions: a mixed-methods process evaluation of an action implementation toolbox in intensive care.Implementation science : IS · 2019Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
backgroundAs part of a larger study examining the effectiveness of the Maternal Newborn Dashboard, an electronic audit and feedback system to improve maternal-newborn care practices and outcomes, the purpose of this study was to increase our understanding of factors explaining variability in performance after implementation of the Dashboard in Ontario, Canada.
methodsA collective case study. A maximum variation sampling approach was used to invite hospitals reflecting different criteria to participate in a 1-day to 2-day site visit by the research team. The visits included: (1) semistructured interviews and focus groups with healthcare providers, leaders and personnel involved in clinical change processes; (2) observations and document review. Interviews and focus groups were audio-recorded and transcribed verbatim. Qualitative content analysis was used to code and categorise the data.
resultsBetween June and November 2016, we visited 14 maternal-newborn hospitals. Hospitals were grouped into four quadrants based on their key indicator performance and level of engagement with the Dashboard. Findings revealed four overarching themes that contribute to the varying success of sites in achieving practice change on the Dashboard key performance indicators, namely, interdisciplinary collaboration and accountability, application of formal change strategies, team trust and use of evidence and data, as well as alignment with organisational priorities and support.
conclusionThe diversity of facilitators and barriers across the 14 hospitals highlights the need to go beyond a 'one size fits all' approach when implementing audit and feedback systems. Future work to identify tools to assess barriers to practice change and to evaluate the effects of cointerventions to optimise audit and feedback systems for clinical practice change is needed.
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