Measuring Persistence of Implementation
Author Information
Author(s): Candice C. Bowman, Elisa J. Sobo, Steven M. Asch, Allen L. Gifford
Primary Institution: VA San Diego Healthcare System
Hypothesis
How can we effectively measure the sustainability of quality improvement programs in healthcare?
Conclusion
The combination of computerized clinical reminders and group-based quality improvement collaboratives was effective in improving overall care quality for HIV patients.
Supporting Evidence
- Real-time computerized clinical reminders modestly improve chronic disease care processes.
- Group-based quality improvement collaboratives can enhance the effectiveness of interventions.
- Intervention effects were sustained for one year at nearly all sites that showed significant increases in performance.
Takeaway
This study looked at how to keep healthcare improvements going after they start, showing that using reminders and teamwork can help doctors provide better care.
Methodology
A quasi-experimental design was used with 4091 patients in 16 VA facilities, comparing four groups: computerized reminders, group-based quality improvement, both, and controls.
Potential Biases
There may be biases due to the self-reported nature of the data and the lack of randomization in the follow-up analysis.
Limitations
The study was limited by the lack of a control group during the follow-up period and potential contamination of non-intervention sites.
Participant Demographics
Participants were patients receiving care at 16 VA facilities, primarily focusing on HIV care.
Statistical Information
P-Value
0.05
Confidence Interval
1.16–6.0
Statistical Significance
p = 0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website