The role of theory in research to develop and evaluate the implementation of patient safety practices | AHRQ Patient Safety Network

The role of theory in research to develop and evaluate the implementation of patient safety practices.

Foy R, Ovretveit J, Shekelle PG, et al. BMJ Qual Saf. 2011 Feb 11; [Epub ahead of print].

The first decade of the patient safety movement has seen notable successes, but many highly publicized practices have been less impactful than anticipated. This AHRQ-funded expert panel calls for patient safety researchers to explicitly incorporate theories of individual behavior change and organizational improvement into the planning, implementation, and evaluation of patient safety research. Using established theoretical models has the potential to improve the odds of successful implementation of safety practices and increase the generalizability of successful strategies for other institutions. The importance of behavior change models in implementing checklists was discussed in a recent commentary, and Dr. Brent James—one of the nation's leading physician quality improvement experts—discussed his use of change theories in an AHRQ WebM&M interview.

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AHRQ Patient Safety Network

Qual Saf Health Care. 2011 Feb 11. [Epub ahead of print]

The role of theory in research to develop and evaluate the implementation of patient safety practices.
Foy R, Ovretveit J, Shekelle PG, Pronovost PJ, Taylor SL, Dy S, Hempel S, McDonald KM, Rubenstein LV, Wachter RM.

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Abstract
Theories provide a way of understanding and predicting the effects of patient safety practices (PSPs), interventions intended to prevent or mitigate harm caused by healthcare or risks of such harm. Yet most published evaluations make little or no explicit reference to theory, thereby hindering efforts to generalise findings from one context to another. Theories from a wide range of disciplines are potentially relevant to research on PSPs. Theory can be used in research to explain clinical and organisational behaviour, to guide the development and selection of PSPs, and in evaluating their implementation and mechanisms of action. One key recommendation from an expert consensus process is that researchers should describe the theoretical basis for chosen intervention components or provide an explicit logic model for 'why this PSP should work.' Future theory-driven evaluations would enhance generalisability and help build a cumulative understanding of the nature of change.

PMID: 21317181 [PubMed - as supplied by publisher]
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