tailieunhanh - báo cáo khoa học: "Disseminating quality improvement: study protocol for a large cluster-randomized trial"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Disseminating quality improvement: study protocol for a large cluster-randomized trial | Quanbeck et al. Implementation Science 2011 6 44 http content 6 1 44 Implementation Science IMPLEMENTATION SCIENCE STUDY PROTOCOL Open Access Disseminating quality improvement study protocol for a large cluster-randomized trial 1 1 1 1 2 Andrew R Quanbeck David H Gustafson James H Ford II Alice Pulvermacher Michael T French K John McConnell3 and Dennis McCarty4 Abstract Background Dissemination is a critical facet of implementing quality improvement in organizations. As a field addiction treatment has produced effective interventions but disseminated them slowly and reached only a fraction of people needing treatment. This study investigates four methods of disseminating quality improvement QI to addiction treatment programs in the . It is to our knowledge the largest study of organizational change ever conducted in healthcare. The trial seeks to determine the most cost-effective method of disseminating quality improvement in addiction treatment. Methods The study is evaluating the costs and effectiveness of different QI approaches by randomizing 201 addiction-treatment programs to four interventions. Each intervention used a web-based learning kit plus monthly phone calls coaching face-to-face meetings or the combination of all three. Effectiveness is defined as reducing waiting time days between first contact and treatment increasing program admissions and increasing continuation in treatment. Opportunity costs will be estimated for the resources associated with providing the services. Outcomes The study has three primary outcomes waiting time annual program admissions and continuation in treatment. Secondary outcomes include voluntary employee turnover treatment completion and operating margin. We are also seeking to understand the role of mediators moderators and other factors related to an organization s success in making changes. Analysis We are fitting a mixed-effect regression model to each program s average monthly waiting

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