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Evaluating the effect of a web-based quality improvement system with feedback and outreach visits on guideline concordance in the field of cardiac rehabilitation: rationale and study protocol

Overview of attention for article published in Implementation Science, December 2014
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  • Good Attention Score compared to outputs of the same age (66th percentile)
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4 tweeters
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2 Facebook pages

Citations

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15 Dimensions

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105 Mendeley
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Title
Evaluating the effect of a web-based quality improvement system with feedback and outreach visits on guideline concordance in the field of cardiac rehabilitation: rationale and study protocol
Published in
Implementation Science, December 2014
DOI 10.1186/s13012-014-0131-y
Pubmed ID
Authors

Mariëtte M van Engen-Verheul, Nicolette F de Keizer, Sabine N van der Veer, Hareld MC Kemps, Wilma JM Scholte op Reimer, Monique WM Jaspers, Niels Peek

Abstract

BackgroundImplementation of clinical practice guidelines into daily care is hampered by a variety of barriers related to professional knowledge and collaboration in teams and organizations. To improve guideline concordance by changing the clinical decision-making behavior of professionals, computerized decision support (CDS) has been shown to be one of the most effective instruments. However, to address barriers at the organizational level, additional interventions are needed. Continuous monitoring and systematic improvement of quality are increasingly used to achieve change at this level in complex health care systems. The study aims to assess the effectiveness of a web-based quality improvement (QI) system with indicator-based performance feedback and educational outreach visits to overcome organizational barriers for guideline concordance in multidisciplinary teams in the field of cardiac rehabilitation (CR).MethodsA multicenter cluster-randomized trial with a balanced incomplete block design will be conducted in 18 Dutch CR clinics using an electronic patient record with CDS at the point of care. The intervention consists of (i) periodic performance feedback on quality indicators for CR and (ii) educational outreach visits to support local multidisciplinary QI teams focussing on systematically improving the care they provide. The intervention is supported by a web-based system which provides an overview of the feedback and facilitates development and monitoring of local QI plans. The primary outcome will be concordance to national CR guidelines with respect to the CR needs assessment and therapy indication procedure. Secondary outcomes are changes in performance of CR clinics as measured by structure, process and outcome indicators, and changes in practice variation on these indicators. We will also conduct a qualitative process evaluation (concept-mapping methodology) to assess experiences from participating CR clinics and to gain insight into factors which influence the implementation of the intervention.DiscussionTo our knowledge, this will be the first study to evaluate the effect of providing performance feedback with a web-based system that incorporates underlying QI concepts. The results may contribute to improving CR in the Netherlands, increasing knowledge on facilitators of guideline implementation in multidisciplinary health care teams and identifying success factors of multifaceted feedback interventions.Trial registration NTR3251.

Twitter Demographics

The data shown below were collected from the profiles of 4 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 105 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 2%
Chile 1 <1%
United Kingdom 1 <1%
Unknown 101 96%

Demographic breakdown

Readers by professional status Count As %
Student > Master 21 20%
Student > Ph. D. Student 14 13%
Researcher 13 12%
Student > Bachelor 8 8%
Other 6 6%
Other 22 21%
Unknown 21 20%
Readers by discipline Count As %
Medicine and Dentistry 29 28%
Nursing and Health Professions 12 11%
Psychology 8 8%
Computer Science 7 7%
Social Sciences 6 6%
Other 18 17%
Unknown 25 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 January 2015.
All research outputs
#6,524,665
of 12,786,466 outputs
Outputs from Implementation Science
#979
of 1,335 outputs
Outputs of similar age
#96,582
of 289,926 outputs
Outputs of similar age from Implementation Science
#66
of 103 outputs
Altmetric has tracked 12,786,466 research outputs across all sources so far. This one is in the 48th percentile – i.e., 48% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,335 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.9. This one is in the 25th percentile – i.e., 25% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 289,926 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.
We're also able to compare this research output to 103 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.