Evidence map›Paper›PMID 33596305›Full record

ArticleAge and ageing2021

How quality improvement collaboratives work to improve healthcare in care homes: a realist evaluation.

Reena Devi, Neil H Chadborn, Julienne Meyer, Jay Banerjee, Claire Goodman, Tom Dening, John R F Gladman, Kathryn Hinsliff-Smith, Annabelle Long, Adeela Usman and 7 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
8.1field-weighted citation impact, top 2% 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

19 citing papers in PubMed, 39 citations in OpenAlex.

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  19. Research into ageing and frailty.Future healthcare journal · 2021
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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

17 authors at 9 institutions in 1 country.

Reena DeviSchool of Healthcare, University of Leeds, Leeds, UK.
Neil H ChadbornSchool of Medicine, University of Nottingham, Nottingham, UK.
Julienne MeyerSchool of Health Sciences, City University of London, London, UK.
Jay BanerjeeUniversity Hospitals of Leicester NHS Trust, University of Leicester, Leicester, and Loughborough University, Loughborough, UK.
Claire GoodmanSchool of Health and Social Work, University of Hertfordshire, Hatfield, UK.ORCID 0000-0002-8938-4893
Tom DeningSchool of Medicine, University of Nottingham, Nottingham, UK.
John R F GladmanSchool of Medicine, University of Nottingham, Nottingham, UK.
Kathryn Hinsliff-SmithFaculty of Health and Life Sciences, De Montfort University, Leicester, UK.
Annabelle LongSchool of Medicine, University of Nottingham, Nottingham, UK.
Adeela UsmanSchool of Medicine, University of Nottingham, Nottingham, UK.
Gemma HousleyNottingham University Hospitals NHS Trust, Nottingham, UK.
Sarah LewisSchool of Medicine, University of Nottingham, Nottingham, UK.
Matthew GloverSurrey Health Economics Centre, University of Surrey, Guildford, UK.
Heather GageSurrey Health Economics Centre, University of Surrey, Guildford, UK.
Philippa A LoganSchool of Medicine, University of Nottingham, Nottingham, UK.
Finbarr C MartinPopulation Health Sciences, King's College London, London, UK.ORCID 0000-0002-6911-3498
Adam L GordonSchool of Medicine, University of Nottingham, Nottingham, UK.
University of Nottingham · GBUniversity of Surrey · GBCity, University of London · GBDe Montfort University · GBKing's College London · GBLoughborough University · GBNottingham University Hospitals NHS Trust · GBUniversity of Hertfordshire · GBUniversity of Leeds · GB

Funding

Department of Health 11/1021/02
6 · The paper itself

Abstract

backgroundQuality improvement collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used to support healthcare improvement in care homes is not fully understood.

methodsA realist evaluation to develop and test a programme theory of how QICs work to improve healthcare in care homes. A multiple case study design considered implementation across 4 sites and 29 care homes. Observations, interviews and focus groups captured contexts and mechanisms operating within QICs. Data analysis classified emerging themes using context-mechanism-outcome configurations to explain how NHS and care home staff work together to design and implement improvement.

resultsQICs will be able to implement and iterate improvements in care homes where they have a broad and easily understandable remit; recruit staff with established partnership working between the NHS and care homes; use strategies to build relationships and minimise hierarchy; protect and pay for staff time; enable staff to implement improvements aligned with existing work; help members develop plans in manageable chunks through QI coaching; encourage QIC members to recruit multidisciplinary support through existing networks; facilitate meetings in care homes and use shared learning events to build multidisciplinary interventions stepwise. Teams did not use measurement for change, citing difficulties integrating this into pre-existing and QI-related workload.

conclusionsThese findings outline what needs to be in place for health and social care staff to work together to effect change. Further research needs to consider ways to work alongside staff to incorporate measurement for change into QI.

Indexed as

Cooperative BehaviorQuality ImprovementDelivery of Health CareHumansNursing HomesQuality of Health Carehealth services researchnursing homesolder peopleprimary carequality improvementquality improvement collaboratives

Identifiers

PMID33596305
PMCPMC8522714
OpenAlexW3131453641

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.