Continuous quality improvement: effects on professional practice and healthcare outcomes

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows: 1. The principle objective will be to determine from existing evidence the relative effectiveness of continuous quality improvement approaches compared with standard health care practices, the sustainability of the outcomes, and the associated costs. 2. A secondary objective will be to determine from existing evidence the relative effectiveness of continuous quality improvement approaches compared with other interventions to change professional practice such as academic detailing or guidelines, the sustainability of the outcomes, and the associated costs. 3. A series of tertiary objectives address various aspects of continuous quality improvement approaches which might influence their effectiveness in different settings: Does the relative effectiveness of continuous quality improvement approaches increase as the complexity of the proposed changes increases (e.g. more changes, more staff involved, different professions, facilities or departments involved)? Is there a relationship between the implementation strategy adopted for initiating and supporting activities and the effectiveness of continuous quality improvement approaches (e.g. trained facilitator from outside the setting compared with facilitation by a trained staff member, training all staff in a workshop, or written guidance only)? Is there a relationship between the timing, frequency and duration of meetings and the effectiveness of continuous quality improvement approaches (e.g. multiple short meetings within a wide time-frame versus occasional long meetings within a wide time-frame versus short or long meetings within a short time frame)? Is there evidence that group meetings (e.g. meetings with doctors as a group and nurses as a group, meetings with doctors and nurses together) improve the effectiveness of continuous quality improvement approaches compared to approaches which mainly involve interactions between individuals (e.g. individual meetings with each doctor and each nurse)?