ArticleBMJ quality & safety2020
Exploring the sustainability of quality improvement interventions in healthcare organisations: a multiple methods study of the 10-year impact of the 'Productive Ward: Releasing Time to Care' programme in English acute hospitals.
Article in BMJ quality & safety, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
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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.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Identifying and understanding benefits associated with return-on-investment from large-scale healthcare Quality Improvement programmes: an integrative systematic literature review.BMC health services research · 2022Pooled it
- Sustained effects of the INFORM cluster randomized trial: an observational post-intervention study.Implementation science : IS · 2021Trial
- A comparison of intensive vs. light-touch quality improvement interventions for maternal health in Uttar Pradesh, India.BMC health services research · 2020Trial
- The development of the sustainability measure for healthcare using a modified Delphi process.BMC health services research · 2025Article
- Coproducing Quality and Safety Improvement Projects in Resource-Constrained Countries: Lessons From Mozambique.International journal of public health · 2025Article
- Toward value-based care using cost mining: cost aggregation and visualization across the entire colorectal cancer patient pathway.BMC medical research methodology · 2024Article
- A nurse by any other name? An international comparison of nomenclature and regulation of healthcare assistants.International journal of nursing studies advances · 2024Article
- Adopting, implementing and assimilating coproduced health and social care innovations involving structurally vulnerable populations: findings from a longitudinal, multiple case study design in Canada, Scotland and Sweden.Health research policy and systems · 2024Article
- The Irish national chronic obstructive pulmonary disease quality improvement collaborative: an adaptive learning collaborative.BMJ open quality · 2024Article
- A cross-organizational Lean deployment in an Italian regional healthcare system.International journal of health care quality assurance · 2023Article
- How is return on investment from quality improvement programmes conceptualised by mental healthcare leaders and why: a qualitative study.BMC health services research · 2023Review
- Looking Back, Looking Forward: A Study Protocol for a Mixed-Methods Multiple-Case Study to Examine Improvement Sustainability of Large-Scale Initiatives in Tertiary Hospitals.Healthcare (Basel, Switzerland) · 2023Article
- Sustaining improvement of hospital-wide initiative for patient safety and quality: a systematic scoping review.BMJ open quality · 2022Article
- The feasibility and validity of using a real time location system (RTLS) to measure bedside contact time.Journal of research in nursing : JRN · 2022Article
- Healthcare Quality Improvement Analytics: An Example Using Computerized Provider Order Entry.Healthcare (Basel, Switzerland) · 2021Article
- Article
- How, why and under what circumstances does a quality improvement collaborative build knowledge and skills in clinicians working with people with dementia? A realist informed process evaluation.BMJ open quality · 2021Article
- Commentary: National clinical programmes in the Republic of Ireland: a qualitative study of acute hospitals.Journal of research in nursing : JRN · 2020Article
- Evidence-Based Analysis of Protected Mealtime Policies on Patient Nutrition and Care.Risk management and healthcare policy · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe 'Productive Ward: Releasing Time to Care' programme is a quality improvement (QI) intervention introduced in English acute hospitals a decade ago to: (1) Increase time nurses spend in direct patient care. (2) Improve safety and reliability of care. (3) Improve experience for staff and patients. (4) Make changes to physical environments to improve efficiency.
objectiveTo explore how timing of adoption, local implementation strategies and processes of assimilation into day-to-day practice relate to one another and shape any sustained impact and wider legacies of a large-scale QI intervention.
designMultiple methods within six hospitals including 88 interviews (with Productive Ward leads, ward staff, Patient and Public Involvement representatives and senior managers), 10 ward manager questionnaires and structured observations on 12 randomly selected wards.
resultsResource constraints and a managerial desire for standardisation meant that, over time, there was a shift away from the original vision of empowering ward staff to take ownership of Productive Ward towards a range of implementation 'short cuts'. Nonetheless, material legacies (eg, displaying metrics data; storage systems) have remained in place for up to a decade after initial implementation as have some specific practices (eg, protected mealtimes). Variations in timing of adoption, local implementation strategies and contextual changes influenced assimilation into routine practice and subsequent legacies. Productive Ward has informed wider organisational QI strategies that remain in place today and developed lasting QI capabilities among those meaningfully involved in its implementation.
conclusionsAs an ongoing QI approach Productive Ward has not been sustained but has informed contemporary organisational QI practices and strategies. Judgements about the long-term sustainability of QI interventions should consider the evolutionary and adaptive nature of change processes.
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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.