Survey-based Work System Assessment to Facilitate Large-scale Dissemination of Healthcare Quality Improvement Programs

Anping Xie; Danielle W Koontz; Annie Voskertchian; James C Fackler; Aaron M Milstone; Charlotte Z Woods-Hill

doi:10.1097/pq9.0000000000000288

Survey-based Work System Assessment to Facilitate Large-scale Dissemination of Healthcare Quality Improvement Programs

Pediatr Qual Saf. 2020 Apr 9;5(2):e288. doi: 10.1097/pq9.0000000000000288. eCollection 2020 Mar-Apr.

Authors

Anping Xie^{1

2}, Danielle W Koontz³, Annie Voskertchian³, James C Fackler², Aaron M Milstone^{1

3

4}, Charlotte Z Woods-Hill⁵

Affiliations

¹ Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Md.
² Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md.
³ Department of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Md.
⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
⁵ Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pa.

Abstract

Introduction: The dissemination of quality improvement (QI) interventions to a broader range of healthcare settings requires a proactive assessment of local work systems and processes. The objective of this study was to examine the feasibility of using a survey-based work system assessment (WSA) tool to facilitate the dissemination of a program for optimizing blood culture (BC) use.

Methods: Informed by findings from an onsite, interview-based WSA at 2 hospitals, a 50-item WSA survey was devised and administrated to 15 hospitals participating in a QI collaborative. WSA survey data were summarized, shared, and discussed with individual hospitals to inform the adaptation and implementation of the BC program. Physician champions leading the local QI team assessed the use of the WSA survey by completing an 8-item survey.

Results: A total of 347 clinicians completed the WSA survey, and physician champions at 12 hospitals evaluated the use of the WSA survey. Both the WSA survey data and the evaluation of the WSA survey showed that the survey-based WSA tool could help participating hospitals understand their current BC ordering practices and identify potential barriers to implementing the program from the perspectives of different clinicians.

Conclusions: We demonstrated how a survey-based tool could be used to facilitate WSA in the dissemination of a program for improving BC use to a multisite collaborative. A survey-based WSA tool can be used to facilitate future large-scale intervention dissemination efforts.

Abstract

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