ArticleImplementation science : IS2019
Facilitating action planning within audit and feedback interventions: a mixed-methods process evaluation of an action implementation toolbox in intensive care.
Article in Implementation science : IS, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02922101 (Increasing the Effectiveness and Understanding of Audit and Feedback Interventions in Intensive Care), which is not on this map. Cited by 18 papers, 3 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.
Increasing the Effectiveness and Understanding of Audit and Feedback Interventions in Intensive Care: Protocol for a Mixed-methods Study
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Methods used to design audit and feedback interventions to change clinical practice: a scoping review.Frontiers in health services · 2026Pooled it
- A Systematic Review of Electronic Medical Record Driven Quality Measurement and Feedback Systems.International journal of environmental research and public health · 2022Pooled it
- Understanding how and why audits work in improving the quality of hospital care: A systematic realist review.PloS one · 2021Pooled it
- Data Resource Profile Update: The Dutch National Intensive Care Evaluation (NICE) registry.International journal of epidemiology · 2026Article
- Article
- Do process evaluations open up the 'black box' of implementation interventions in health care? A scoping review.Implementation science : IS · 2025Article
- Audit and group feedback in nursing home physician groups: lessons learned from a qualitative study.BMC health services research · 2025Article
- Fostering continuous quality improvement in a European rare disease network.Frontiers in health services · 2025Article
- Impact of provider feedback on quality improvement in rehabilitation services: an interrupted time series analysis.Frontiers in rehabilitation sciences · 2025Article
- A realist synthesis of multicentre comparative audit implementation: exploring what works and in which healthcare contexts.BMJ open quality · 2024Review
- Thought Leader Perspectives on the Benefits, Barriers, and Enablers for Routinely Collected Electronic Health Data to Support Professional Development: Qualitative Study.Journal of medical Internet research · 2023Article
- Feedback on audit and action planning for dental caries control: a qualitative study to investigate the acceptability among interdisciplinary pediatric dental care teams.Frontiers in oral health · 2023Article
- Healthcare professionals' perspectives on implementation of universal tumor DNA testing in ovarian cancer patients: multidisciplinary focus groups.Familial cancer · 2023Article
- Article
- Process evaluations undertaken alongside randomised controlled trials in the hospital setting: A scoping review.Contemporary clinical trials communications · 2022Article
- Article
- Implementing a digital patient feedback system: an analysis using normalisation process theory.BMC health services research · 2020Article
- Revitalising audit and feedback to improve patient care.BMJ (Clinical research ed.) · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundAudit and feedback (A&F) is more effective if it facilitates action planning, but little is known about how best to do this. We developed an electronic A&F intervention with an action implementation toolbox to improve pain management in intensive care units (ICUs); the toolbox contained suggested actions for improvement. A head-to-head randomised trial demonstrated that the toolbox moderately increased the intervention's effectiveness when compared with A&F only.
objectiveTo understand the mechanisms through which A&F with action implementation toolbox facilitates action planning by ICUs to increase A&F effectiveness.
methodsWe extracted all individual actions from action plans developed by ICUs that received A&F with (n = 10) and without (n = 11) toolbox for 6 months and classified them using Clinical Performance Feedback Intervention Theory. We held semi-structured interviews with participants during the trial. We compared the number and type of planned and completed actions between study groups and explored barriers and facilitators to effective action planning.
resultsICUs with toolbox planned more actions directly aimed at improving practice (p = 0.037) and targeted a wider range of practice determinants compared to ICUs without toolbox. ICUs with toolbox also completed more actions during the study period, but not significantly (p = 0.142). ICUs without toolbox reported more difficulties in identifying what actions they could take. Regardless of the toolbox, all ICUs still experienced barriers relating to the feedback (low controllability, accuracy) and organisational context (competing priorities, resources, cost).
conclusionsThe toolbox helped health professionals to broaden their mindset about actions they could take to change clinical practice. Without the toolbox, professionals tended to focus more on feedback verification and exploring solutions without developing intentions for actual change. All feedback recipients experienced organisational barriers that inhibited eventual completion of actions.
trial registrationClinicalTrials.gov, NCT02922101 . Registered on 26 September 2016.
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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.