Network evaluation of an innovation platform in continuous quality improvement in Australian Indigenous primary healthcare

Frances Clare Cunningham, Boyd Alexander Potts, Shanthi Ann Ramanathan, Jodie Bailie, Roxanne Gwendalyn Bainbridge, Andrew Searles, Alison Frances Laycock, Ross Stewart Bailie

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Abstract

Background: From 2014 to 2019, the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI) was evaluated as an innovation platform focusing on continuous quality improvement in Indigenous Australian primary healthcare. Although social network analysis (SNA) is a recognized method for evaluating the functioning, collaboration and effectiveness of innovation platforms, applied research is limited. This study applies SNA to evaluate the CRE-IQI’s functioning as an innovation platform. Methods: Two surveys (2017, 2019) were conducted using social survey and network methods. Survey items covered respondent characteristics, their perceptions of the CRE-IQI’s performance, and its impact and sociometric relationships. Members’ relationship information was captured for the CRE-IQI at three time points, namely start (retrospectively), midpoint and final year, on three network types (knew, shared information, collaborated). SNA software was used to compute standard network metrics including diameter, density and centrality, and to develop visualizations. Survey and network results were addressed in a workshop held by members to develop improvement strategies. Results: The response rate was 80% in 2017 and 65% in 2019 (n = 49 and 47, respectively). Between 2017 and 2019, respondents’ mean ratings of the CRE-IQI’s functioning and achievements in meeting its goals were sustained. They perceived the CRE-IQI as multidisciplinary, having effective management and governance, and incorporating Indigenous research leadership, representation and ways of working. Respondents recognized high levels of trust amongst members, rated “good communication and coordination with participants” highly, and “facilitating collaboration” as the CRE’s most strongly recognized achievement. In collaboration and information-sharing networks, average path length remained low in 2017 and 2019, indicating good small-world network properties for relaying information. On average, respondents shared information and collaborated with more CRE members in 2017 than 2019. However, in both 2017 and 2019 there were new collaborations and information-sharing outside of direct collaborations. CRE-IQI outcomes included: evidence generation; knowledge transfer and skills development in quality improvement; research capacity-building, career development; mentoring; grant support; development of new projects; health service support; and policy impact. Conclusions: This study shows the utility of network analysis in evaluating the functioning, and collaboration, at the individual, organizational and health system levels, of an innovation platform, and adds to our understanding of factors enabling successful innovation platforms.

Original languageEnglish
Article number119
Pages (from-to)1-18
Number of pages18
JournalHealth Research Policy and Systems
Volume20
Issue number1
DOIs
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
The goals of the CRE-IQI were to (1) refine and build new processes and tools; (2) improve data reporting systems; (3) improve the use of quality improvement data in clinical governance, management and practice; (4) build quality improvement capacity in the Indigenous workforce and (5) monitor and evaluate the impact of the CRE-IQI. There were three cross-cutting work programs to (1) promote the transfer of research outcomes into health policy and practice, (2) develop the capacity of the health and medical research workforce and (3) facilitate collaboration. The CRE-IQI built on the membership of the predecessor research entity, the ABCD National Research Partnership, and was open to new membership from the wider networks of current members and their organizations []. The CRE-IQI actively invited new membership on a nationwide basis from organizations and agencies involved in quality improvement research in Indigenous PHC. The CRE-IQI held biannual face-to-face meetings, with research masterclasses conducted in association with the meetings. Online monthly research capacity-building seminars were also held. Seed funding and other support was available for emerging research projects, and scholarship support for postgraduate students. Further details about how the CRE-IQI operated as an innovation platform are published elsewhere [, , , ].

Funding Information:
Strengthening primary healthcare (PHC) systems is vital to improving health outcomes and reducing inequity [–]. The disparities in health status and inequitable access to healthcare for Aboriginal and Torres Strait Islander Australians (hereafter, respectfully referred to collectively as Indigenous Australians) compared with the rest of the Australian population are widely recognized []. The Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI) was funded by the Australian National Health and Medical Research Council to operate from November 2014 to November 2019 as an innovation platform for systems-wide improvement in Indigenous PHC. It aimed to foster collaborations between researchers, service providers and policy-makers for priority-driven research and implementation, thereby strengthening state-of-the-art quality improvement systems in Indigenous PHC across Australia. The CRE-IQI drew on international experience of innovation platforms to expand the partnership learning model established through the predecessor research entity, the ABCD National Research Partnership, and other work associated with the CRE-IQI [–].

Funding Information:
We sincerely thank the members of the CRE-IQI who contributed to this study, and the members of the CRE-IQI evaluation group (Jodie Bailie, Ross Bailie, Roxanne Bainbridge, Frances Cunningham, Chris Doran, Alison Laycock, Boyd Potts, Shanthi Ramanathan and Andrew Searles). From November 2014 to November 2017, the coordinating centre for the CRE-IQI was based at Menzies School of Health Research, Charles Darwin University, Brisbane, and from December 2017 to December 2019 at the University Centre for Rural Health, University of Sydney, Lismore. We thank Mietta Russell for her research assistance for this study associated with her 2017 University of Queensland Bachelor of Health Sciences student placement at Menzies School of Health Research.

Publisher Copyright:
© 2022, The Author(s).

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