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Incorporating evidence review into quality improvement: meeting the needs of innovators
  1. Margie Sherwood Danz1,2,
  2. Susanne Hempel1,
  3. Yee-Wei Lim1,3,
  4. Roberta Shanman1,
  5. Aneesa Motala1,
  6. Susan Stockdale2,
  7. Paul Shekelle1,2,
  8. Lisa Rubenstein1,2
  1. 1RAND Corporation, Santa Monica, California, USA
  2. 2Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California, USA
  3. 3Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
  1. Correspondence to Dr Margie Sherwood Danz, RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA; mjsdanz{at}gmail.com

Abstract

Background Achieving quality improvement (QI) aims often requires local innovation. Without objective evidence review, innovators may miss previously tested approaches, rely on biased information, or use personal preferences in designing and implementing local QI programmes.

Aim To develop a practical, responsive approach to evidence review for QI innovations aimed at both achieving the goals of the Patient Centered Medical Home (PCMH) and developing an evidence-based QI culture.

Design Descriptive organisational case report.

Methods As part of a QI initiative to develop and spread innovations for achieving the Veterans Affairs (VA) PCMH (termed Patient Aligned Care Team, or PACT), we involved a professional evidence review team (consisting of review experts, an experienced librarian, and administrative support) in responding to the evidence needs of front-line primary care innovators. The review team developed a systematic approach to responsive innovation evidence review (RIER) that focused on innovator needs in terms of time frame, type of evidence and method of communicating results. To assess uptake and usefulness of the RIERs, and to learn how the content and process could be improved, we surveyed innovation leaders.

Results In the first 16 months of the QI initiative, we produced 13 RIERs on a variety of topics. These were presented as 6–15-page summaries and as slides at a QI collaborative. The RIERs focused on innovator needs (eg, topic overviews, how innovations are carried out, or contextual factors relevant to implementation). All 17 innovators who responded to the survey had read at least one RIER; 50% rated the reviews as very useful and 31%, as probably useful.

Conclusions These responsive evidence reviews appear to be a promising approach to integrating evidence review into QI processes.

  • Quality improvement
  • Evidence-based medicine
  • Medical homes

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjqs-2012-001722

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