Project summary 

Background

Health systems internationally are attempting to address the issue of how to monitor and regulate quality of care in order to maintain and drive up standards. In the UK, policy initiatives focused upon institutional level reporting of quality of care indicators and revalidation for clinicians raise questions around how best to feedback and use data to support improvement at different levels of the health system. This PhD will investigate the factors influencing the effectiveness of data feedback as an intervention to improve care. The programme of research will be based around three core work streams; use of feedback at the individual level, use of feedback at the clinical unit level and use of feedback at the institutional level. At each of these levels design characteristics of effective feedback will be identified and used to develop and evaluate new or existing information systems. The research design will be mixed methods, with qualitative and quasi-experimental components used to evaluate enhanced data feedback models from a sociotechnical perspective which takes account of effectiveness for different stakeholders, acceptability to end users and unintended consequences. The work will adopt a multidisciplinary approach that includes psychological theory, organisational studies, medical informatics and health services research themes. Research questions will be pursued within multiple service contexts, with the early phases grounded within an ongoing quality monitoring initiative in anaesthesia. 

Outputs

Conference presentations

• D’Lima, D., Sacks, M., & Benn, J. Qualitative psychological research in health service improvement: Striking the right balance. Qualitative Methods in Psychology BPS Conference, Sep 2013.
• D’Lima, D., Moore, J., Arnold, G. & Benn, J. Determining the important characteristics of quality monitoring and feedback to improve anaesthetic care. Oral presentation accepted at International
• Society for Quality in Healthcare Annual Conference, Edinburgh (2013).
• D’Lima D., Moore, J., Arnold, G. & Benn, J. Performance feedback to healthcare professionals: What supports behaviour change? Oral presentation accepted at European Health Psychology Society Annual Conference, Bordeaux (2013).
• D’Lima, D., Moore, J., Arnold, G. & Benn, J. Impact of a local quality monitoring programme in anaesthesia: A mixed methods evaluation. Oral presentation accepted at Evidence Based PeriOperative Medicine (EBPOM) Annual Conference, London (2013).
• D'Lima D, Sacks M, Blackman W & Benn J (2013). The Reliability of Surgical Swab Counting: The Scrub Nurse's Perspective. Poster at the BMJ Quality and Safety Forum, April, London, UK.