Table 2.
Quality improvement methodology relevant to various steps of research studies
| Research component | Related quality improvement methodology |
|---|---|
| Development of study question |
Patient co-design to ensure meaning/relevance to patients Stakeholder analysis for adequate depth of engagement of various groups (e.g., patients/caregivers, front-line interprofessional providers, departmental leaders, executive sponsors at upper leadership level) Identification of a problem statement to guide planning Building a burning platform to ensure local leadership commitment, stakeholder engagement and front-line buy-in (e.g., champions) Consideration of hybrid designs (e.g., quasi-experimental, interrupted time-series), especially when randomization impossible |
| Protocol development and intervention(s) selection |
Ishikawa (fishbone) diagram to identify all relevant causal elements for the interprofessional team Process mapping of complex systems to illustrate optimal flow and timing of intervention(s), as well as feasibility within local context (e.g., early identification of system barriers) Effort-Impact diagram and/or Driver diagram of change ideas and drivers towards the overall aim to select the highest-yield approaches Rapid-cycle iteration (i.e. Plan-Do-Study-Act cycles) and refinement of intervention(s) through pilot testing to ensure their highest-yield impact once implemented in a defined study protocol |
| Evaluation and analytical plan |
Repeated data sampling to assess progress toward aims, detect change, and improve efficiency Run chart and/or Statistical process control (SPC) chart to identify special cause variation (i.e. signal in the noise of expected process variation) Effectiveness-implementation hybrid designs |
| Scale, spread and sustainability planning |
Consideration of contexts (micro, meso and macro-levels) to ensure success and replicability Use of highly adoptable improvement model for long-term sustainability Use of models for spread |