Understanding the role of external facilitation to drive quality improvement for stroke care in hospitals
Journal article
Thayabaranathan, Tharshanah, Andrew, Nadine E., Grimley, Rohan, Stroil-Salama, Enna, Grabsch, Brenda, Hill, Kelvin, Cadigan, Greg, Purvis, Tara, Middleton, Sandy, Kilkenny, Monique F. and Cadilhac, Dominique A.. (2021). Understanding the role of external facilitation to drive quality improvement for stroke care in hospitals. Healthcare. 9(9), p. Article 1095. https://doi.org/10.3390/healthcare9091095
Authors | Thayabaranathan, Tharshanah, Andrew, Nadine E., Grimley, Rohan, Stroil-Salama, Enna, Grabsch, Brenda, Hill, Kelvin, Cadigan, Greg, Purvis, Tara, Middleton, Sandy, Kilkenny, Monique F. and Cadilhac, Dominique A. |
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Abstract | The use of external facilitation within the context of multicomponent quality improvement interventions (mQI) is growing. We aimed to evaluate the influence of external facilitation for improving the quality of acute stroke care. Clinicians from hospitals participating in mQI (Queensland, Australia) as part of the Stroke123 study were supported by external facilitators in a single, on-site workshop to review hospital performance against eight clinical processes of care (PoCs) collected in the Australian Stroke Clinical Registry (AuSCR) and develop an action plan. Remote support (i.e., telephone/email) after the workshop was provided. As part of a process evaluation for Stroke123, we recorded the number and mode of contacts between clinicians and facilitators; type of support provided; and frequency of self-directed, hospital-level stroke registry data reviews. Analysis: We measured the association between amount/type of external facilitation, (i) development of action plans, and (ii) adherence to PoCs before and after the intervention using AuSCR data from 2010 to 2015. In total, 14/19 hospitals developed an action plan. There was no significant difference in amount or type of external facilitator support provided between hospitals that did, and did not, develop an action plan. There was no relationship between the amount of external facilitation and change in adherence to PoCs. Most (95%) hospitals accessed stroke registry performance data. In the Stroke123 study, the amount or type of external facilitation did not influence action plan development, and the amount of support did not influence the changes achieved in adherence to PoCs. Remote support may not add value for mQI. |
Keywords | quality improvement; stroke; facilitation; behavior change intervention; process evaluation; improvement science |
Year | 2021 |
Journal | Healthcare |
Journal citation | 9 (9), p. Article 1095 |
Publisher | MDPI AG |
ISSN | 2227-9032 |
Digital Object Identifier (DOI) | https://doi.org/10.3390/healthcare9091095 |
PubMed ID | 34574869 |
Scopus EID | 2-s2.0-85113965771 |
PubMed Central ID | PMC8471416 |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1-12 |
Funder | National Health and Medical Research Council (NHMRC) |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 25 Aug 2021 |
Publication process dates | |
Accepted | 20 Aug 2021 |
Deposited | 28 Nov 2021 |
Grant ID | NHMRC/1034415 |
NHMRC/1063761 | |
NHMRC/1072053 | |
NHMRC/1109426 |
https://acuresearchbank.acu.edu.au/item/8x1zz/understanding-the-role-of-external-facilitation-to-drive-quality-improvement-for-stroke-care-in-hospitals
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Publisher's version
OA_Thayabaranathan_2021_Understanding_the_role_of_external_facilitation.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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