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Evaluating investment in quality improvement capacity building: a systematic review

PURPOSE: Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for s...

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Autores principales: Mery, Gustavo, Dobrow, Mark J, Baker, G Ross, Im, Jennifer, Brown, Adalsteinn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337696/
https://www.ncbi.nlm.nih.gov/pubmed/28219957
http://dx.doi.org/10.1136/bmjopen-2016-012431
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author Mery, Gustavo
Dobrow, Mark J
Baker, G Ross
Im, Jennifer
Brown, Adalsteinn
author_facet Mery, Gustavo
Dobrow, Mark J
Baker, G Ross
Im, Jennifer
Brown, Adalsteinn
author_sort Mery, Gustavo
collection PubMed
description PURPOSE: Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. METHODS: We searched for evaluations of QI capacity building and evaluations of QI training programmes. We included the most relevant indexed databases in the field and a strategic search of the grey literature. The latter included direct electronic scanning of 85 relevant government and institutional websites internationally. Data were extracted regarding evaluation design and common assessment themes and components. RESULTS: 48 articles met the inclusion criteria. 46 articles described initiative-level non-economic evaluations of QI capacity building/training, while 2 studies included economic evaluations of QI capacity building/training, also at the initiative level. No system-level QI capacity building/training evaluations were found. We identified 17 evaluation components that fit within 5 overarching dimensions (characteristics of QI training; characteristics of QI activity; individual capacity; organisational capacity and impact) that should be considered in evaluations of QI capacity building. 8 key steps in return-on-investment (ROI) assessments in QI capacity building were identified: (1) planning—stakeholder perspective; (2) planning—temporal perspective; (3) identifying costs; (4) identifying benefits; (5) identifying intangible benefits that will not be included in the ROI estimation; (6) discerning attribution; (7) ROI calculations; (8) sensitivity analysis. CONCLUSIONS: The literature on QI capacity building evaluation is limited in the number and scope of studies. Our findings, summarised in a Framework to Guide Evaluations of QI Capacity Building, can be used to start closing this knowledge gap.
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spelling pubmed-53376962017-03-07 Evaluating investment in quality improvement capacity building: a systematic review Mery, Gustavo Dobrow, Mark J Baker, G Ross Im, Jennifer Brown, Adalsteinn BMJ Open Health Services Research PURPOSE: Leading health systems have invested in substantial quality improvement (QI) capacity building, but little is known about the aggregate effect of these investments at the health system level. We conducted a systematic review to identify key steps and elements that should be considered for system-level evaluations of investment in QI capacity building. METHODS: We searched for evaluations of QI capacity building and evaluations of QI training programmes. We included the most relevant indexed databases in the field and a strategic search of the grey literature. The latter included direct electronic scanning of 85 relevant government and institutional websites internationally. Data were extracted regarding evaluation design and common assessment themes and components. RESULTS: 48 articles met the inclusion criteria. 46 articles described initiative-level non-economic evaluations of QI capacity building/training, while 2 studies included economic evaluations of QI capacity building/training, also at the initiative level. No system-level QI capacity building/training evaluations were found. We identified 17 evaluation components that fit within 5 overarching dimensions (characteristics of QI training; characteristics of QI activity; individual capacity; organisational capacity and impact) that should be considered in evaluations of QI capacity building. 8 key steps in return-on-investment (ROI) assessments in QI capacity building were identified: (1) planning—stakeholder perspective; (2) planning—temporal perspective; (3) identifying costs; (4) identifying benefits; (5) identifying intangible benefits that will not be included in the ROI estimation; (6) discerning attribution; (7) ROI calculations; (8) sensitivity analysis. CONCLUSIONS: The literature on QI capacity building evaluation is limited in the number and scope of studies. Our findings, summarised in a Framework to Guide Evaluations of QI Capacity Building, can be used to start closing this knowledge gap. BMJ Publishing Group 2017-02-20 /pmc/articles/PMC5337696/ /pubmed/28219957 http://dx.doi.org/10.1136/bmjopen-2016-012431 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) 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/4.0/
spellingShingle Health Services Research
Mery, Gustavo
Dobrow, Mark J
Baker, G Ross
Im, Jennifer
Brown, Adalsteinn
Evaluating investment in quality improvement capacity building: a systematic review
title Evaluating investment in quality improvement capacity building: a systematic review
title_full Evaluating investment in quality improvement capacity building: a systematic review
title_fullStr Evaluating investment in quality improvement capacity building: a systematic review
title_full_unstemmed Evaluating investment in quality improvement capacity building: a systematic review
title_short Evaluating investment in quality improvement capacity building: a systematic review
title_sort evaluating investment in quality improvement capacity building: a systematic review
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337696/
https://www.ncbi.nlm.nih.gov/pubmed/28219957
http://dx.doi.org/10.1136/bmjopen-2016-012431
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