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How Quality Improvement Practice Evidence Can Advance the Knowledge Base

O'Rourke, Hannah M.; Fraser, Kimberly D.

The Journal for Healthcare Quality (JHQ): September/October 2016 - Volume 38 - Issue 5 - p 264–274
doi: 10.1097/JHQ.0000000000000067
Original Article
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Abstract: Recommendations for the evaluation of quality improvement interventions have been made in order to improve the evidence base of whether, to what extent, and why quality improvement interventions affect chosen outcomes. The purpose of this article is to articulate why these recommendations are appropriate to improve the rigor of quality improvement intervention evaluation as a research endeavor, but inappropriate for the purposes of everyday quality improvement practice. To support our claim, we describe the differences between quality improvement interventions that occur for the purpose of practice as compared to research. We then carefully consider how feasibility, ethics, and the aims of evaluation each impact how quality improvement interventions that occur in practice, as opposed to research, can or should be evaluated. Recommendations that fit the evaluative goals of practice-based quality improvement interventions are needed to support fair appraisal of the distinct evidence they produce. We describe a current debate on the nature of evidence to assist in reenvisioning how quality improvement evidence generated from practice might complement that generated from research, and contribute in a value-added way to the knowledge base.

For more information on this article, contact Hannah M. O'Rourke at.

The authors declare no conflict of interest.

Funding: This work was supported by Alberta Innovates Health Solutions; the Canadian Institutes for Health Research; and Knowledge Translation Canada [all training awards to H.M.O.].

© 2016 National Association for Healthcare Quality
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