Table 5.
Evidence to support CMOc2: the degree of importance of continuous monitoring, audit, and feedback on sustainability of a scaled, multi-component intervention
| Case A-002: “So, like the managers and the front-line staff who were part of these [name of intervention] committees, really valued how their units were performing. So really understanding what was happening every day. Not just what they think was happening. And there were often many times where it was like well I thought we were doing way better than that. And it was truly providing a very deeper understanding and insight into their daily unit practices. And that data was key in pushing this intervention forward and making those changes.” |
| Case A-004: “I think that is a huge driving factor [monitoring and feedback]. Because most people in [name of work environment], that is what drives them. If they know, okay this works, this is proven to work… this is the advantages. These are the pros and cons. This is why we need to make it [the intervention] a priority in our day.” |
| Case A-008: “Like I said, I think the reasons to continue supporting it [the intervention] is just because we do get this ongoing feedback on how we are doing. It helps guide us [front-line staff]. Are we doing the right thing? Are we doing the wrong thing? So, what do we have to change? And, you know, obviously seeing improvements in those metrics is motivating to continue doing those behaviors.” |
| Case A-009: “So I think that yes, the audit feedback is hugely important. But we have to be cognizant of peoples’ level of understanding. And also not overwhelming them. The way the data is presented is important so…if you’re presenting data to executive leadership for example and I’m thinking of executive directors, they may look at the data differently than a person at the front-line may look at the data. So they’re going to ask different questions. So I think presenting the data in a way that makes sense to the front-line staff.” |
| Case B-002: “There are so many new things coming at staff all the time that if you don’t keep referring back to results it just slides off people’s awareness. So, I think it is important that information continues to come back to sites whether that’s you know, in a quality board or in staff meetings or whatever. Otherwise it just disappears into the larger field of information that people see. So, I mean we’ve certainly had sites that have, you know, started out with really high levels of [name of clinical issue] that have dropped fairly dramatically. And then you look again, you know, six months or eight months later and their rates are rising again. So, I mean, it’s not just that the numbers are visible. It’s that somebody is actually looking at and them and giving some critical thought to why they’re doing what they’re doing. But I think if that information doesn’t keep coming back, you absolutely will not do that.” |
| Case B-005: “I think personally it’s very important because if we don’t measure and monitor, then how do you even know how you’re doing? So, I know that there’s been interventions in the past that we haven’t put monitoring mechanisms in place. Then it does just become flavor of the month and it kind of falls off the side of the plate. I think it’s important to remember that outside of [name of intervention], that there’s tons of interventions. So, I think it is super important to put in these mechanisms in place to ensure that we don’t get into that flavor of the month syndrome where it’s just dropped off peoples’ desk and it’s an afterthought. But if you’re continuously improving, you’re talking about it, you’re bringing forward the data, you’re having these conversations at meetings that it keeps it top of mind for folks.” |