Evaluating the design and implementation fidelity of an adapted Plan-Do-Study-Act approach to improve health system performance in a Nigerian state |
| |
| Affiliation: | 1. Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;2. Department of Planning, Research and Statistics, National Primary Healthcare Development Agency, Abuja, Nigeria;3. Department of Health Sciences, Bouve College of Health Sciences, Northeastern University, Boston, USA;4. Department of Health Policy, London School of Economics and Political Science, London, UK;5. Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill NC, USA;1. Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA;2. RAND Health Care, RAND Corporation, 776 Main Street, Santa Monica, CA, 90401-3208, USA;3. Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA;4. College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, 33612, USA;5. Morsani College of Medicine and College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL, 33612, USA;1. Johns Hopkins School of Public Health, Baltimore, MD, USA;2. World Vision Korea, Seoul, South Korea;3. World Vision Bangladesh, Dhaka, Bangladesh;4. Seoul National University, Seoul, South Korea;1. Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA;2. Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA;3. Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA;4. Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, 32611, USA;5. Department of Health Policy Management, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA;6. South Carolina Conference of the United Methodist Church, Columbia, SC, 29203, USA;1. Wayne State University, Kinesiology, Health and Sport Studies, United States;2. The University of Texas at Austin, Department of Kinesiology and Health Education, United States;3. RTI International, Center for Behavioral Health Epidemiology, Implementation, and Evaluation Research, United States;4. Centers for Disease Control and Prevention, Division of Population Health, United States |
| |
| Abstract: | BackgroundThe Plan-Do-Study-Act (PDSA) cycle is fundamental to many quality improvement (QI) models. For the approach to be effective in the real-world, variants must align with standard elements of the PDSA. This study evaluates the alignment between theory, design and implementation fidelity of a PDSA variant adapted for Nigeria’s health system performance improvement.MethodsAn iterative consensus building approach was used to develop a scorecard evaluating new conceptual indices of design and implementation fidelity of QI interventions (design and implementation index, defects and gaps) based on Taylor’s theoretical framework.ResultsDesign (adaptation) scores were optimal across all standard features indicating that design was well adapted to the typical PDSA. Conversely, implementation fidelity scores were only optimal with two standard features: prediction-based test of change and the use of data over time. The other features, use of multiple iterative cycles and documentation had implementation gaps of 17 % and 50 % respectively.ConclusionThis study demonstrates how both adaptation and implementation fidelity are important for success of QI interventions. It also presents an approach for evaluating other QI models using Taylor’s PDSA assessment framework as a guide, which might serve to strengthen the theory behind future QI models and provide guidance on their appropriate use. |
| |
| Keywords: | Quality improvement Implementation science PDSA Health system Nigeria Program design |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
