Process evaluation of a data-driven quality improvement program within a cluster randomised controlled trial to improve coronary heart disease management in Australian primary care.

Humans Quality Improvement Primary Health Care Australia Coronary Disease / therapy Female Male Disease Management

Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 17 07 2023
accepted: 30 01 2024
medline: 4 6 2024
pubmed: 4 6 2024
entrez: 4 6 2024
Statut: epublish

Résumé

This study evaluates primary care practices' engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states. Twenty-seven practices participated in the QI intervention from November 2019 -November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices. Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146-252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention. Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions. Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.

Sections du résumé

BACKGROUND BACKGROUND
This study evaluates primary care practices' engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states.
METHODS METHODS
Twenty-seven practices participated in the QI intervention from November 2019 -November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices.
RESULTS RESULTS
Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146-252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention.
CONCLUSION CONCLUSIONS
Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions.
TRIAL REGISTRATION BACKGROUND
Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.

Identifiants

DOI: 10.1371/journal.pone.0298777 PMID: 38833486
pubmed: 38833486
doi: 10.1371/journal.pone.0298777
pii: PONE-D-23-21449
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0298777

Informations de copyright

Copyright: © 2024 Hafiz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The funding body and industry partners were not involved in the design of the study and did not have any role during its execution, analyses, interpretation of the data, or decision to submit results. Amgen and Sanofi Australia have provided cash support to the main study. MW is a consultant to Amgen, Freeline and Kyowa Kirin. Other authors have nothing to disclose. This does not alter our adherence to PLOS ONE policy on sharing data and materials.

Auteurs

Nashid Hafiz (N)

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
ORCID: 0000-0002-5444-1624

Karice Hyun (K)

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
Department of Cardiology, Concord Hospital, ANZAC Research Institute, Sydney, Australia.

Qiang Tu (Q)

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.

Andrew Knight (A)

Primary and Integrated Care Unit, Southwestern Sydney Local Health District, Sydney, Australia.
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
ORCID: 0000-0001-5291-8989

Charlotte Hespe (C)

The University of Notre Dame, School of Medicine, Sydney, Australia.

Clara K Chow (CK)

Western Sydney Local Health District, Sydney, Australia.
Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia.

Tom Briffa (T)

School of Population and Global Health, The University of Western Australia, Perth, Australia.

Robyn Gallagher (R)

Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.

Christopher M Reid (CM)

School of Population Health, Curtin University, Perth, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
ORCID: 0000-0001-9173-3944

David L Hare (DL)

University of Melbourne and Austin Health, Melbourne, Australia.

Nicholas Zwar (N)

Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia.

Mark Woodward (M)

The George Institute for Global Health, University of New South Wales, Sydney, Australia.
The George Institute for Global Health, School of Public Health, Imperial College London, United Kingdom.

Stephen Jan (S)

The George Institute for Global Health, University of New South Wales, Sydney, Australia.

Emily R Atkins (ER)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.

Tracey-Lea Laba (TL)

Clinical and Health Sciences, University of South Australia, Adelaide, Australia.

Elizabeth Halcomb (E)

School of Nursing, University of Wollongong, Wollongong, Australia.

Tracey Johnson (T)

Inala Primary Care, Brisbane, Queensland, Australia.

Deborah Manandi (D)

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.

Tim Usherwood (T)

Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.

Julie Redfern (J)

School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Process evaluation of a data-driven quality...
questionsmedicales.fr › Administration des services de santé › Amélioration de la qualité › Process evaluation of a data-driven quality...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Process evaluation of a data-driven quality...
questionsmedicales.fr › Régions géographiques › Océanie › Australasie › Australie › Process evaluation of a data-driven quality...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Ischémie myocardique › Maladie coronarienne › Process evaluation of a data-driven quality...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Prise en charge de la maladie › Process evaluation of a data-driven quality...