Skip to main content
SpringerLink
Log in

Multi-institutional Learning and Collaboration to Improve Quality and Safety

  • Chapter
  • First Online:
Surgical Patient Care

Abstract

A quality improvement collaborative (QIC) is a broad-based approach to identifying and adopting best practices and implementing rapid organizational change. Participants share a commitment to making small, rapid tests of change that can be expanded to produce breakthrough results in a specific clinical or operational area. Historically, QICs have been effective in improving targeted topics, with evidence of positive spill-over effects on participating teams in other areas of care. State-wide surgical QICs, with varying degrees of involvement and components, have increased in prevalence in recent years with aim of decreasing complications after surgery. Such QICs have been formed in Washington, Tennessee, Florida, and Illinois and have achieved varying degrees of success in improving surgical outcomes. The Illinois Surgical Quality Improvement Collaborative has used a conceptual model to guide their QIC to influence the Hospital, Surgical QI Team, and Perioperative Microsystem levels, which translates to five major domains: guided implementation, education, comparative performance reports, networking, and funding.

A successful collaborative has been described as one that has a solid structural foundation (governance, funding, technological recourses, etc.), and one that is able to achieve collaborative learning across organizational boundaries (a multifaceted, noncompetitive team, varying levels of skill among facilitators, providing networking sessions and sustainment throughout program, etc.). Importantly, an effective team structure and strong leadership has been identified as key elements. Champions, for example, support acceptance of new ideas, have the clout to fight barriers to change and project completion.

Creating and maintaining a collaborative is resource intensive, requiring significant financial and labor support. Therefore, it is critical to evaluate the most effective way to learn and engage front line clinicians in the QIC process. Consolidated Framework for Implementation Research (CFIR) offers one such method of evaluating the effectiveness, cost-effectiveness, and success factors of a collaborative. The success and widespread adoption of collaborative methodology, and its evaluation, depends on meaningful exchanges and insights among experts and peers who apply best practices to improve care.

“If you want to go fast, go alone. If you want to go far, go together.”

—African Proverb

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ayers LR, Beyea SC, Godfrey MM, Harper DC, Nelson EC, Batalden PB. Quality improvement learning collaboratives. Qual Manag Health Care. 2005;14:234–47.

    Article  PubMed  Google Scholar 

  2. Sollecito WA, Johnson JK, editors. McLaughlin and Kaluzny’s continuous quality improvement in health care. 4th ed. Burlington, MA: Jones and Bartlett Learning; 2013.

    Google Scholar 

  3. Barach P, Winters M, Potter Forbes M. NSW trauma and rehabilitation improvement collaborative. NSW Life Time Care and Support Agency; 2011.

    Google Scholar 

  4. Schouten LM, Hulscher ME, van Everdingen JJ, Huijsman R, Grol RP. Evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008;336:1491–4.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mittman BS. Creating the evidence base for quality improvement collaboratives. Ann Intern Med. 2004;140:897–901.

    Article  PubMed  Google Scholar 

  6. Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in health services organizations. Oxford, UK: Blackwell Publishing Inc; 2005.

    Book  Google Scholar 

  7. Overtveit J, Bate P, Cleary P, et al. Quality collaboratives: lessons from research. Qual Saf Health Care. 2002;11:345–51.

    Article  Google Scholar 

  8. Wenger E, McDermott R, Synder W. Cultivating communities of practice. Boston, MA: Harvard Business School Press; 2002.

    Google Scholar 

  9. Kislov R, Harvey G, Walshe K. Collaborations for leadership in applied health research and care: lessons from the theory of communities of practice. Implement Sci. 2011;6:64.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Young JQ, et al. Advancing the next generation of handover research and practice with cognitive load theory. BMJ Qual Saf. 2016;25:66–70. doi:10.1136/bmjqs-2015-004181.

    Article  PubMed  Google Scholar 

  11. Davis K, Drey N, Gould D. What are scoping studies? A review of the nursing literature. Int J Nurs Stud. 2009;46:1386–400.

    Article  PubMed  Google Scholar 

  12. Health at a Glance 2013: OECD indicators. OECD Publishing; 2013. http://dx.doi.org/10.1787/health_glance-2013-en. Accessed 31 Aug 2015.

    Google Scholar 

  13. Batalden M, Batalden P, Margolis P, et al. Coproduction of healthcare services. BMJ Qual Saf. 2016;25:1–9.

    Article  Google Scholar 

  14. Campbell Jr DA, Kubus JJ, Henke PK, Hutton M, Englesbe MJ. The Michigan Surgical Quality Collaborative: a legacy of Shukri Khuri. Am J Surg. 2009;198:S49–55.

    Article  PubMed  Google Scholar 

  15. SCOAP Collaborative, Writing Group for the SCOAP Collaborative, Kwon S, Florence M, et al. Creating a learning healthcare system in surgery: Washington State’s Surgical Care and Outcomes Assessment Program (SCOAP) at 5 years. Surgery. 2012;151:146–52.

    Article  Google Scholar 

  16. Guillamondegui OD, Gunter OL, Hines L, et al. Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to improve surgical outcomes. J Am Coll Surg. 2012;214:709–14. discussion 14-6.

    Article  PubMed  Google Scholar 

  17. Dellinger EP, Hausmann SM, Bratzler DW, et al. Hospitals collaborate to decrease surgical site infections. Am J Surg. 2005;190:9–15.

    Article  PubMed  Google Scholar 

  18. Minami C, Sheils C, Bilimoria K, et al. Process improvement in surgery. Curr Probl Surg. 2016;52:49–96.

    Google Scholar 

  19. Nadeem E, Olin SS, Hill LC, Hoagwood KE, Horwitz SM. Understanding the components of quality improvement collaboratives: a systematic literature review. Milbank Q. 2013;91:354–94.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nembhard IM. Learning and improving in quality improvement collaboratives: which collaborative features do participants value most? Health Serv Res. 2009;44:359–78.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hall B, Hamilton B, Richards K, Bilimoria K, Cohen M, Ko C. Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals. Ann Surg. 2009;250:363–76.

    PubMed  Google Scholar 

  22. Hall B, Richards K, Ingraham A, Ko C. New approaches to the National Surgical Quality Improvement Program: the American College of Surgeons experience. Am J Surg. 2009;198:S56–62.

    Article  PubMed  Google Scholar 

  23. Wandling MW, Minami CA, Johnson JK, O’Leary KJ, Yang AD, Holl JL, Bilimoria KY. Development of a conceptual model for surgical quality improvement collaboratives facilitating the implementation and evaluation of collaborative quality improvement. JAMA Surg. 2016;151(12):1181–3. doi:10.1001/jamasurg.2016.2817.

    Article  PubMed  Google Scholar 

  24. Gauthier A. The challenge of stewardship: building learning organizations in healthcare. In: Chawla S, Renesch J, editors. Learning organizations. Portland, OR: Productivity Press; 1995.

    Google Scholar 

  25. Ovretveit J, Bate P, Cleary P, et al. Quality collaboratives: lessons from research. Qual Saf Health Care. 2002;11:345–51.

    Article  CAS  PubMed  Google Scholar 

  26. Mohr J, Batalden P, Barach P. Integrating patient safety into the clinical microsystem. Qual Saf Health Care. 2004;13:34–8.

    Article  Google Scholar 

  27. Leape LL, Kabcenell AI, Gandhi TK, Carver P, Nolan TW, Berwick DM. Reducing adverse drug events: lessons from a breakthrough series collaborative. Jt Comm J Qual Improv. 2000;26:321–31.

    CAS  PubMed  Google Scholar 

  28. Kaluzny A, Veney J, Gentry J. Innovation of health services: a comparative study of hospitals and health departments. Milbank Mem Fund Q. 1974;52:51–82.

    Article  CAS  Google Scholar 

  29. Lofland J, Lofland L. Analyzing social settings. Belmont, CA: Wadsworth Publishing Company; 2006.

    Google Scholar 

  30. Bogdan R, Biklen S. Qualitative research for education: an introduction to theory and methods. Boston: Allyn & Bacon; 1992.

    Google Scholar 

  31. Lilford R, Chilton PJ, Hemming K, Brown C, Girling A, Barach P. Evaluating policy and service interventions: framework to guide selection and interpretation of study end points. BMJ. 2010;341:c4413.

    Article  PubMed  Google Scholar 

  32. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.

    Article  PubMed  PubMed Central  Google Scholar 

  33. 7th annual conference on the science of dissemination and implementation: transforming health systems to optimize individual and population health. Cohosted by AcademyHealth and the National Institutes of Health, 2014 December 8–9, Bethesda, MD; 2014.

    Google Scholar 

  34. Smith L, Laura Damschroder L, Lewis C, Weiner B. The consolidated framework for implementation research: advancing implementation science through real-world applications, adaptations, and measurement. 7th annual conference on the science of dissemination and implementation, Bethesda, MD; 2014.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, 633 North St Clair, Chicago, IL, 60611, USA

    Julie K. Johnson MSPH, PhD

  2. Department of Surgery, Surgical Outcomes and Quality Improvement Center, Feinberg School of Medicine, Northwestern University, 633 N. St. Clair Street, 20th Floor, Chicago, IL, 60611, USA

    Christina A. Minami MD, MS, Allison R. Dahlke MPH & Karl Y. Bilimoria MD, MS

Authors
  1. Julie K. Johnson MSPH, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christina A. Minami MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Allison R. Dahlke MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karl Y. Bilimoria MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julie K. Johnson MSPH, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery Ascension Saint Agnes Hospital Armstrong Institute for Patient Safety & Quality, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Juan A. Sanchez

  2. Children’s Cardiomyopathy Foundation and Kyle John Rymiszewski Research Scholar, Children’s Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA

    Paul Barach

  3. Department of Surgery Center for Healthcare Studies Institute for Public Health and Medicine Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Julie K. Johnson

  4. Division of Cardiovascular Surgery Johns Hopkins All Children’s Heart Institute Johns Hopkins All Children’s Hospital, Johns Hopkins University, Saint Petersburg, FL, USA

    Jeffrey P. Jacobs

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Johnson, J.K., Minami, C.A., Dahlke, A.R., Bilimoria, K.Y. (2017). Multi-institutional Learning and Collaboration to Improve Quality and Safety. In: Sanchez, J., Barach, P., Johnson, J., Jacobs, J. (eds) Surgical Patient Care. Springer, Cham. https://doi.org/10.1007/978-3-319-44010-1_42

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-44010-1_42

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-44008-8

  • Online ISBN: 978-3-319-44010-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation