Barriers and facilitators to the implementation of the collaborative method: reflections from a single site
BMJ Quality & SafetyPublished 30 November 2007Open access
Phillip J. Newton, Elizabeth Halcomb, Patricia M. Davidson, A. Robert Denniss
Citations50
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The potential for the collaborative approach to improve clinical outcomes warrants further systematic evaluation of process issues and consideration of the barriers and facilitators to implementation in various settings.
Abstract
The findings from this study underscore the importance of leadership, communication and team cohesion for the successful implementation of the collaborative method at individual sites. In addition, the importance of a preparatory stage that deals with known barriers and facilitators to the collaborative method before the commencement of the official study period was highlighted. The potential for the collaborative approach to improve clinical outcomes warrants further systematic evaluation of process issues and consideration of the barriers and facilitators to implementation in various settings.
Keywords
Health Professions
Medical Entomology and ZoologySocial Foundations of Thought and Action : A Social Cognitive Theory
19,075 Citations1986Albert Bandura
Medical Entomology and ZoologyThe Practice of Nursing Research: Conduct, Critique, & Utilization
3,654 Citations1987Nancy Nancy, Burns +1 more
This chapter discusses the research process, methodology, ethics in research, and strategies for using research in practice in the context of nursing practice.
JAMAChanging physician performance. A systematic review of the effect of continuing medical education strategies
2,602 Citations1995D A Davis
Milbank QuarterlyImproving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change
1,357 Citations2001Ewan Ferlı́e, Stephen M. Shortell
The multilevel change framework and associated properties provide a framework for assessing progress along the journey in efforts to sustain the impetus for quality improvement over time.
Cochrane Database of Systematic ReviewsEducational outreach visits: effects on professional practice and health care outcomes
1,294 Citations2007Mary Ann O’Brien, Stephen Rogers +10 more
EOVs alone or when combined with other interventions have effects on prescribing that are relatively consistent and small, but potentially important and their effects on other types of professional performance vary from small to modest improvements, and it is not possible from this review to explain that variation.
The Canadian Journal of SociologyParticipant Observation: A Methodology for Human Studies
1,257 Citations1990Robert Prus, Danny L. Jorgensen
Medical Entomology and ZoologyQualitative Research in Nursing
725 Citations2002Immy Holloway, Stephanie Wheeler
Part I: Introduction to Qualitative Research 1. The Nature of QualitativeResearch: Development and Perspectives 2. Initial Steps in the Research Process 3. Ethical Issues in Qualitative research 4. Supervision in Qual quantitative research 5. Interviewing 6. Participant Observation and Documents as Sources of Data
BMJ Quality & SafetyQuality collaboratives: lessons from research
566 Citations2002John Øvretveit
These guidelines are likely to be useful for collaborative organisers, teams and their managers and may also contribute to further research into collaboratives and the spread of innovations in health care.
Annals of Internal MedicineDeveloping and Testing Changes in Delivery of Care
531 Citations1998Donald M. Berwick
The art of medical care involves a continuing, individualized search in which the physician tries to match incomplete scientific knowledge of disease and treatment with incomplete local knowledge about particular patients at particular times in their lives, called the Plan-Do-Study-Act (PSA) cycle.
Quality Management in Health CareA Framework for Collaborative Improvement
481 Citations1998Charles M. Kilo
Health Services ResearchAssessment of Chronic Illness Care (ACIC): A Practical Tool to Measure Quality Improvement
399 Citations2002Amy E. Bonomi, Edward H. Wagner +2 more
Results and feedback from teams suggest that the ACIC is responsive to health care quality-improvement efforts and may be a useful tool to guide quality improvement in chronic illness care and to track progress over time.
Journal of Advanced NursingSelf‐efficacy as a predictor of academic performance in science
279 Citations1998Sharon Andrew
The Self-Efficacy for Science was designed to predict academic performance in the science areas of a first-year undergraduate nursing course and revealed the SEFS contained six instead of the hypothesized four factors, which could explain 70% of students' self-efficacy for science.
The Joint Commission Journal on Quality and SafetyWhat Do Collaborative Improvement Projects Do? Experience from Seven Countries
211 Citations2003Tim Wilson, Donald M. Berwick +1 more
Systematically studying the impact of variations in the seven key features of collaboratives could yield important information about their role and impact.
Health Services ResearchAssessing the Implementation of the Chronic Care Model in Quality Improvement Collaboratives
208 Citations2005Marjorie L. Pearson, Shinyi Wu +8 more
Collaborative participants were able, with some important variation, to implement large numbers of diverse QI change strategies, with high CCM fidelity and modest depth of implementation, suggesting QI collaboratives are a useful method to foster change in real world settings.
The Joint Commission Journal on Quality ImprovementReducing Adverse Drug Events: Lessons from a Breakthrough Series Collaborative
197 Citations2000Lucian L. Leape, Andrea Kabcenell +4 more
Success in making significant changes was associated with strong leadership, effective processes, and appropriate choice of intervention and teams were able to define, clearly state, and relentlessly pursue their aims.
Evaluation ReviewAn Evaluation of Collaborative Interventions to Improve Chronic Illness Care
169 Citations2004Shan Cretin, Stephen M. Shortell +1 more
Data collection on 37 participating organizations, 22 control sites, and more than 4,000 patients with diabetes, congestive heart failure, asthma, or depression is nearing completion, and when analyzed, will shed new light on the effectiveness of collaborative improvement methods and the CCM.
BirthReducing Cesarean Section Rates Safely: Lessons from a “Breakthrough Series” Collaborative
152 Citations1998Bruce L. Flamm, Donald M. Berwick +1 more
The Healthy People 2000 goal of a cesarean delivery rate below 15 percent by the year 2000 is attainable and clinical leadership from doctors and nurses toward the achievement of that goal is timely, ethical, and in the best interests of childbearing women in the United States.
Cochrane Database of Systematic ReviewsEducational outreach visits: effects on professional practice and health care outcomes
130 Citations1997MA O'Brien, AD Oxman +4 more
The Joint Commission Journal on Quality and SafetyCharacteristics of Successful Quality Improvement Teams: Lessons from Five Collaborative Projects in the VHA
126 Citations2004Peter D. Mills, William B. Weeks
It is recommended that quality improvement teams become integrated with their organization's key strategic goals, that improvement teams stay together, and that leadership and team training be provided to improve clinical outcomes.
Psychiatric ServicesImplementation and Maintenance of Quality Improvement for Treating Depression in Primary Care
101 Citations2006Lisa S. Meredith, Peter Mendel +7 more
Despite substantial challenges, there was evidence of broad success at implementation and maintenance of quality improvement for depression treatment in primary care.
Journal of Clinical OncologyMultidisciplinary Systems Approach to Chemotherapy Safety: Rebuilding Processes and Holding the Gains
88 Citations2002Richard B. Womer, Ellen Tracy +4 more
Applying systems change concepts to the inpatient chemotherapy delivery system, this work has achieved an 84% decrease in the number of chemotherapy errors that actually reach patients per 1,000 chemotherapy doses, and has sustained that improvement for 5 years.
Health Promotion InternationalHow can health bureaucracies consult effectively about their policies and practices?: some lessons from an Australian study
44 Citations1997Christine Putland
The research suggests that while the skills and performance of individual officers are important, there are several key organisational indicators in the government bureaucracy itself which will determine its ability to consult effectively.
MCN The American Journal of Maternal/Child NursingReducing Cesarean Section Rates Safely: Lessons from a "Breakthrough Series"
44 Citations1999Ellen Tate Patterson
International Journal of Health Care Quality AssuranceHow to run an effective improvement collaborative
33 Citations2002John Øvretveit
It is concluded that by following these suggestions, a successful collaborative is not certain, but that waste of time and money will be less likely.
International Journal for Quality in Health CareThe Victorian emergency department collaboration
29 Citations2002J. G. Bartlett, Peter Cameron +1 more
The spread of knowledge and innovation can be best facilitated rapidly by teams working together using a structured program in a supported environment.
The Joint Commission Journal on Quality and SafetyA Rapid-Cycle Collaborative Model to Promote Guidelines for Acute Myocardial Infarction
26 Citations2003Cecelia Montoye, Rajendra H. Mehta +8 more
Developing and fostering a collaborative culture allowed hospital teams to avoid barriers or overcome them successfully based on others' experiences and collectively solve problems, and it shortened the learning curve and accelerated QI.
The Journal of Cardiovascular NursingAn Introduction to the Collaborative Methodology and Its Potential Use for the Management of Heart Failure
21 Citations2006Phillip J. Newton, Patricia M. Davidson +3 more
The collaborative methodology, when implemented and conducted according to key conceptual principles, has significant potential to improve the outcomes of patients, particularly those with HF and chronic cardiovascular disease.
The Joint Commission Journal on Quality ImprovementSSM Health Care Clinical Collaboratives: Improving the Value of Patient Care in a Health Care System
14 Citations2001Andrew L. Kosseff, Shelley Niemeier
The collaboratives provide an environment for clinicians to constructively participate in improvement of patient care and accelerate improvement work through sharing of successes and failures and peer influence within a reinforcing environment.
PubMedBeyond survival: toward continuous improvement in medical care.
14 Citations1998Kilo Cm, Andrea Kabcenell +1 more
The needs for and benefits of continuous improvement are discussed along with a description of its basic elements and the approaches outlined can serve to greatly increase the pace of improvement in health care.
Quality Management in Health CareBreakthrough Change for Adult Cardiac Surgery in a Community-Based Cardiovascular Program
8 Citations1998Karen A. Doran, Sharon Henry +1 more
The hospital participated in the Breakthrough Series: collaborative adult cardiac surgery sponsored by the Institute of Healthcare Improvement and there was no adverse impact on the clinical indicators 30-day readmission rate, reintubation, return to operating room, and mortality.
Quality Management in Health CareMultidisciplinary Achievement
8 Citations1998Eva B. Besserman, Marie Brennan +3 more
A multidisciplinary group from Muhlenberg Regional Medical Center's intensive care unit learned methodology at the Institute for Health Care Improvement (IHI) Breakthrough Series in Adult Intensive Care in April 1996 and developed a hospital-wide collaborative cost containment team.
Assessing the Implementation of the Chronic Care Model in Quality Improvement Collaboratives: Does Baseline System Support for Chronic Care Matter?
8 Citations2003Shinyi Wu, Marjorie L. Pearson +7 more