Developing a Quality Improvement Implementation Taxonomy for Organizational Employee Wellness Initiatives

BACKGROUND

Standardized taxonomies (STs) facilitate knowledge representation and semantic interoperability within health care provision and research. However, a gap exists in capturing knowledge representation to classify, quantify, qualify, and codify the intersection of evidence and quality improvement (QI) implementation. This interprofessional case report leverages a novel semantic and ontological approach to bridge this gap.

OBJECTIVES

This report had two objectives. First, it aimed to synthesize implementation barrier and facilitator data from employee wellness QI initiatives across Veteran Affairs health care systems through a semantic and ontological approach. Second, it introduced an original framework of this use-case-based taxonomy on implementation barriers and facilitators within a QI process.

METHODS

We synthesized terms from combined datasets of all-site implementation barriers and facilitators through QI cause-and-effect analysis and qualitative thematic analysis. We developed the Quality Improvement and Implementation Taxonomy (QIIT) classification scheme to categorize synthesized terms and structure. This framework employed a semantic and ontological approach. It was built upon existing terms and models from the QI Plan, Do, Study, Act phases, the Consolidated Framework for Implementation Research domains, and the fishbone cause-and-effect categories.

RESULTS

The QIIT followed a hierarchical and relational classification scheme. Its taxonomy was linked to four QI Phases, five Implementing Domains, and six Conceptual Determinants modified by customizable Descriptors and Binary or Likert Attribute Scales.

CONCLUSION

This case report introduces a novel approach to standardize the process and taxonomy to describe evidence translation to QI implementation barriers and facilitators. This classification scheme reduces redundancy and allows semantic agreements on concepts and ontological knowledge representation. Integrating existing taxonomies and models enhances the efficiency of reusing well-developed taxonomies and relationship modeling among constructs. Ultimately, employing STs helps generate comparable and sharable QI evaluations for forecast, leading to sustainable implementation with clinically informed innovative solutions.

Developing a Quality Improvement Implementation Taxonomy for Organizational Employee Wellness Initiatives

BACKGROUND

Standardized taxonomies (STs) facilitate knowledge representation and semantic interoperability within health care provision and research. However, a gap exists in capturing knowledge representation to classify, quantify, qualify, and codify the intersection of evidence and quality improvement (QI) implementation. This interprofessional case report leverages a novel semantic and ontological approach to bridge this gap.

OBJECTIVES

This report had two objectives. First, it aimed to synthesize implementation barrier and facilitator data from employee wellness QI initiatives across Veteran Affairs health care systems through a semantic and ontological approach. Second, it introduced an original framework of this use-case-based taxonomy on implementation barriers and facilitators within a QI process.

METHODS

We synthesized terms from combined datasets of all-site implementation barriers and facilitators through QI cause-and-effect analysis and qualitative thematic analysis. We developed the Quality Improvement and Implementation Taxonomy (QIIT) classification scheme to categorize synthesized terms and structure. This framework employed a semantic and ontological approach. It was built upon existing terms and models from the QI Plan, Do, Study, Act phases, the Consolidated Framework for Implementation Research domains, and the fishbone cause-and-effect categories.

RESULTS

The QIIT followed a hierarchical and relational classification scheme. Its taxonomy was linked to four QI Phases, five Implementing Domains, and six Conceptual Determinants modified by customizable Descriptors and Binary or Likert Attribute Scales.

CONCLUSION

This case report introduces a novel approach to standardize the process and taxonomy to describe evidence translation to QI implementation barriers and facilitators. This classification scheme reduces redundancy and allows semantic agreements on concepts and ontological knowledge representation. Integrating existing taxonomies and models enhances the efficiency of reusing well-developed taxonomies and relationship modeling among constructs. Ultimately, employing STs helps generate comparable and sharable QI evaluations for forecast, leading to sustainable implementation with clinically informed innovative solutions.

Use of a Rubric to Improve the Quality of Internal Medicine Resident Event Reporting

INTRODUCTION

As frontline providers, residents report patient safety events and provide crucial safety feedback. Specific ACGME and AAMC requirements for graduating residents include active participation in event reporting and patient safety investigations. However, formal training on what information a quality event report should include to effect real change in the health care system is lacking.

METHODS

This practical, interactive, case-based workshop educates residents on the key components of a quality event report in a 1-hour time frame. The scoring rubric offers quantitative feedback on the quality of information provided in residents' own event reports. The materials include a presentation template, sample teaching points, pre- and posttraining patient safety cases for residents to complete their own event reports about, and a standardized rubric to score event reports for feedback.

RESULTS

During the fall of 2019, 198 internal medicine residents completed the workshop, and 143 matched pre- and postcourse surveys were reviewed. Residents' ability to correctly identify the key concepts of an event report improved from a median score of 4 to 8 (p < .001). After completion of training, residents reported increased knowledge regarding the content of an effective event report (p < .001) and increased confidence in their ability to write one (p < .001).

DISCUSSION

Residents' knowledge of key event-reporting concepts and confidence in reporting improved after completion of the workshop. This brief interactive training and its novel rubric can be used as a standardized tool for patient safety curricula in academic training programs.