AbstractContinuous quality improvement (CQI) approaches used by healthcare services and teams to improve care systems and health outcomes have potential for informing wider system and policy improvement. The work presented in this thesis investigates this potential and provides knowledge for engaging stakeholders with aggregated CQI data, to inform multi-level system improvement.
A developmental evaluation approach was applied to an online interactive dissemination process through which stakeholders interpreted reports of CQI data aggregated from 175 Indigenous primary health care (PHC) centres across five Australian jurisdictions. The study used mixed methods including document analysis, stakeholder surveys, participant interviews and facilitated processes with the research team. Data analysis guided adaptations to improve the dissemination process and the accessibility and use of its findings, and enhanced understanding about scaling participatory research. The integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was applied retrospectively to analyse stakeholder engagement and implementation.
The study found that system-based participatory research using CQI data, CQI-based methods and established networks could be applied at scale without intense facilitation efforts to support knowledge exchange and improvement. Stakeholders in diverse roles, organisations and settings collaboratively identified system-wide priority evidence-practice gaps, barriers and strategies for improvement across the scope of PHC. Stakeholders perceived the findings to be applicable at different system levels for planning, policy development, identifying research needs, supporting evidence-based care and strengthening capacity in data use. Commitment to best practice, perceived data quality and relevance, reporting formats, facilitation, competing work pressures and the organisational environment for change mediated use.
Interactive dissemination is a promising strategy for system-based knowledge translation and for engaging multi-disciplinary stakeholders in participatory research. Further research should examine the resources required for effective engagement and data use in different contexts, explore facilitation in system-level interventions and investigate further potential of developmental evaluation for supporting implementation.
|Date of Award||Jun 2019|
|Supervisor||Ross Stewart Bailie (Supervisor)|