4 results
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2. Balancing measures or a balanced accounting of improvement impact: a qualitative analysis of individual and focus group interviews with improvement experts in Scotland.
- Author
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Toma, Madalina, Dreischulte, Tobias, Gray, Nicola M., Campbell, Diane, and Guthrie, Bruce
- Subjects
CLINICAL medicine ,FOCUS groups ,INTERVIEWING ,RESEARCH methodology ,MEDICAL quality control ,NATIONAL health services ,QUALITY assurance ,QUALITATIVE research ,JUDGMENT sampling ,KEY performance indicators (Management) - Abstract
Background As quality improvement (QI) programmes have become progressively larger scale, the risks of implementation having unintended consequences are increasingly recognised. More routine use of balancing measures to monitor unintended consequences has been proposed to evaluate overall effectiveness, but in practice published improvement interventions hardly ever report identification or measurement of consequences other than intended goals of improvement. Methods We conducted 15 semistructured interviews and two focus groups with 24 improvement experts to explore the current understanding of balancing measures in QI and inform a more balanced accounting of the overall impact of improvement interventions. Data were analysed iteratively using the framework approach. Results Participants described the consequences of improvement in terms of desirability/undesirability and the extent to which they were expected/ unexpected when planning improvement. Four types of consequences were defined: expected desirable consequences (goals); expected undesirable consequences (trade-offs); unexpected undesirable consequences (unpleasant surprises); and unexpected desirable consequences (pleasant surprises). Unexpected consequences were considered important but rarely measured in existing programmes, and an improvement pause to take stock after implementation would allow these to be more actively identified and managed. A balanced accounting of all consequences of improvement interventions can facilitate staff engagement and reduce resistance to change, but has to be offset against the cost of additional data collection. Conclusion Improvement measurement is usually focused on measuring intended goals, with minimal use of balancing measures which when used, typically monitor trade-offs expected before implementation. This paper proposes that improvers and leaders should seek a balanced accounting of all consequences of improvement across the life of an improvement programme, including deliberately pausing after implementation to identify and quantitatively or qualitatively evaluate any pleasant or unpleasant surprises. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
3. Addressing a gap: a qualitative analysis of Scotland's Drowning and Incident Review process.
- Author
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McAvoy, Carlene, Jagnoor, Jagnoor, and Hoe, Connie
- Subjects
SAFETY ,STAKEHOLDER analysis ,RESEARCH methodology ,PRACTICAL politics ,DROWNING ,MEDICAL incident reports ,EVIDENCE gaps ,INTERVIEWING ,HUMAN services programs ,QUALITATIVE research ,CONCEPTUAL structures ,MEDICAL care use ,DESCRIPTIVE statistics ,JUDGMENT sampling ,THEMATIC analysis ,LEGAL procedure ,CORPORATE culture - Published
- 2023
- Full Text
- View/download PDF
4. Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening: a comparative qualitative study.
- Author
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Kotzur, Marie, McCowan, Colin, Macdonald, Sara, Wyke, Sally, Gatting, Lauren, Campbell, Christine, Weller, David, Crighton, Emilia, Steele, Robert J. C., and Robb, Kathryn A.
- Subjects
BREAST tumor diagnosis ,COLON tumors ,COMPARATIVE studies ,CONSUMER attitudes ,FECAL occult blood tests ,HEALTH attitudes ,INTERVIEWING ,RESEARCH methodology ,MEDICAL care use ,MOTIVATION (Psychology) ,RECTUM tumors ,RESEARCH funding ,STATISTICAL sampling ,CERVIX uteri tumors ,QUALITATIVE research ,JUDGMENT sampling ,SOCIOECONOMIC factors ,THEMATIC analysis ,HEALTH literacy ,EARLY detection of cancer - Abstract
Background In Scotland, the uptake of clinic- based breast (72%) and cervical (77%) screening is higher than home- based colorectal screening (==60%). To inform new approaches to increase uptake of colorectal screening, we compared the perceptions of colorectal screening among women with different screening histories. Methods We purposively sampled women with different screening histories to invite to semistructured interviews: (1) participated in all; (2) participated in breast and cervical but not colorectal ('colorectal-specific non-participants'); (3) participated in none. To identify the sample we linked the data for all women eligible for all three screening programmes in Glasgow, Scotland (aged 51-64 years; n=68 324). Interviews covered perceptions of cancer, screening and screening decisions. Framework method was used for analysis. Results Of the 2924 women invited, 86 expressed an interest, and 59 were interviewed. The three groups' perceptions differed, with the colorectal-specific nonparticipants expressing that: (1) treatment for colorectal cancer is more severe than for breast or cervical cancer; (2) colorectal symptoms are easier to self-detect than breast or cervical symptoms; (3) they worried about completing the test incorrectly; and (4) the colorectal test could be more easily delayed or forgotten than breast or cervical screening. Conclusion Our comparative approach suggested targets for future interventions to increase colorectal screening uptake including: (1) reducing fear of colorectal cancer treatments; (2) increasing awareness that screening is for the asymptomatic; (3) increasing confidence to self- complete the test; and (4) providing a suggested deadline and/or additional reminders. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
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