Evaluating ISQIC Success
Quality Improvement Collaboratives
In recent years, hospital Quality Improvement Collaboratives (QICs) have proliferated where groups of hospitals join together to share knowledge, benchmark performance, and improve common quality and safety issues. While standardized data collection and sharing of comparative performance data are common features of QICs, they are not enough to drive improvement in quality and safety. Furthermore, there is little systematic understanding about which QIC components are effective in generating quality improvement and how to evaluate the success of these components.
ISQIC's 21 Components
ISQIC is an enhanced QIC consisting of 21 components organized into five domains: guided implementation (e.g., mentors and coaches), education (e.g., formal curriculum), hospital- and surgeon-level comparative feedback (e.g., processes, outcomes, costs), annual local and statewide QI projects, and funding (e.g., overall program, pilot grants, bonuses). These components were designed based on evidence, detailed needs assessments, experiences from prior QICs, and interviews with QI experts.
We received an R01 (5R01HS024516; PI: Bilimoria) from the Agency for Healthcare Research and Quality (AHRQ) to evaluate whether providing hospitals with a multi-component quality improvement collaborative improves surgical quality and safety and which of the 21 components contributes most to improving quality. Our research provides detailed insights into how hospitals adapt and implement a QIC to meet local needs and offers new knowledge by identifying the QIC components that are needed by hospitals to facilitate improvement beyond simply measuring outcomes. Ultimately our research addresses the broader need for generalizable models (e.g., tools and approaches) to evaluate how to improve implementation and effectiveness of QICs.
Our research uses mixed methods including site visits to member hospitals, surveys, interviews, and quantitative analyses of process and outcomes data. The site visits have generated local excitement about ISQIC, allowed us to take a deep dive into hospital and surgical culture, and given us valuable information on how the Coordinating Center can better support ISQIC.
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