Imperial College London
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Dr Thomas Woodcock

Faculty of Medicine, School of Public Health

Senior Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 1838thomas.woodcock99

 
 
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Location

 

328Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Poots:2017:10.1136/bmjqs-2017-006756,
author = {Poots, A and Reed, J and Woodcock, T and Bell, D and Goldmann, D},
doi = {10.1136/bmjqs-2017-006756},
journal = {BMJ Quality & Safety},
pages = {933--937},
title = {How to attribute causality in quality improvement: lessons from epidemiology},
url = {http://dx.doi.org/10.1136/bmjqs-2017-006756},
volume = {26},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Quality improvement and implementation (QI&I) initiatives face critical challenges in an era of evidence-based, value-driven patient care. Whether front-line staff, large organisations or government bodies design and run QI&I, there is increasing need to demonstrate impact to justify investment of time and resources in implementing and scaling up an intervention.Decisions about sustaining, scaling up and spreading an initiative can be informed by evidence of causation and the estimated attributable effect of an intervention on observed outcomes. Achieving this in healthcare can be challenging, where interventions often are multimodal and applied in complex systems.1 Where there is weak evidence of causation, credibility in the effectiveness of the intervention is reduced with a resultant reduced desire to replicate. The greater confidence of a causal relationship between QI&I interventions and observed results, the greater our confidence that improvement will result when the intervention occurs in different settings.Guidance exists for design, conduct, evaluation and reporting of QI&I initiatives;2–4; the Standards for QUality Improvement Reporting Excellence (SQUIRE) and the Standards for Reporting Implementation Studies (STARI) guidelines were developed specifically for reporting QI&I initiatives.5 6 However, much of this guidance is targeted at larger formal evaluations, and may require levels of resource or expertise not available to all QI&I initiatives. This paper proposes QI&I initiatives, regardless of scope and resources, can be enhanced by applying epidemiological principles, adapted from those promulgated by Austin Bradford Hill.7
AU  - Poots,A
AU  - Reed,J
AU  - Woodcock,T
AU  - Bell,D
AU  - Goldmann,D
DO  - 10.1136/bmjqs-2017-006756
EP  - 937
PY  - 2017///
SN  - 2044-5423
SP  - 933
TI  - How to attribute causality in quality improvement: lessons from epidemiology
T2  - BMJ Quality & Safety
UR  - http://dx.doi.org/10.1136/bmjqs-2017-006756
UR  - http://hdl.handle.net/10044/1/49089
VL  - 26
ER  -
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