TL;DR: The quality improvement collaborative (QIC) examined by Landon and colleagues in this issue is arguably the health care delivery industry's most important response to quality and safety gaps; it represents substantial investments of time, effort, and funding.
Abstract: Intensive efforts are under way to improve health care quality and safety throughout the United States and abroad. Many of these efforts use the quality improvement collaborative method, an approach emphasizing collaborative learning and exchange of insights and support among a set of health care organizations. Unfortunately, the widespread acceptance and reliance on this approach are based not on solid evidence but on shared beliefs and anecdotal affirmations that may overstate the actual effectiveness of the method. More effective use of the collaborative method will require a commitment by users, researchers, and other stakeholders to rigorous, objective evaluation and the creation of a valid, useful knowledge and evidence base. Development of this evidence base will require improved conceptions of the nature of quality problems, quality improvement processes, and the types of research needed to elucidate these processes. Researchers, journal editors, and funding agencies must also cooperate to ensure that published evaluations are relevant, comprehensive, and cumulative.
TL;DR: A formative reliability analysis of an online, collaborative method for evaluating quality of learning objects within a Convergent Participation evaluation model that brings together instructional designers, media developers, and instructors is presented.
Abstract: Learning objects offer increased ability to share learning resources so that system-wide production costs can be reduced. But how can users select from a set of similar learning objects in a repository and be assured of quality? This article reviews recent developments in the establishment of learning object repositories and metadata standards, and presents a formative reliability analysis of an online, collaborative method for evaluating quality of learning objects. The method uses a 10-item Learning Object Review Instrument (LORI) within a Convergent Participation evaluation model that brings together instructional designers, media developers, and instructors. The inter-rater reliability analysis of 12 raters evaluating eight learning objects identified specific items in LORI that require further development. Overall, the collaborative process substantially increased the reliability and validity of aggregate learning object ratings. The study concludes with specific recommendations including changes to LORI items, a rater training process, and requirements for selecting an evaluation team.
TL;DR: After a review of various collaborative testing methods, this nursing faculty implemented a collaborative testing format that addresses both the positive and negative aspects of the process.
TL;DR: This study showed that the perceived need for tailoring standard change ideas to local contexts and the complexity of aligning interests of involved departments hampered the use of the QIC method for process redesign.
Abstract: Despite the widespread use of quality improvement collaboratives (QICs), evidence underlying this method is limited. A QIC is a method for testing and implementing evidence-based changes quickly across organisations. To extend the knowledge about conditions under which QICs can be used, we explored in this study the applicability of the QIC method for process redesign. We evaluated a Dutch process redesign collaborative of seventeen project teams using a multiple case study design. The goals of this collaborative were to reduce the time between the first visit to the outpatient's clinic and the start of treatment and to reduce the in-hospital length of stay by 30% for involved patient groups. Data were gathered using qualitative methods, such as document analysis, questionnaires, semi-structured interviews and participation in collaborative meetings. Application of the QIC method to process redesign proved to be difficult. First, project teams did not use the provided standard change ideas, because of their need for customised solutions that fitted with context-specific causes of waiting times and delays. Second, project teams were not capable of testing change ideas within short time frames due to: the need for tailoring changes ideas and the complexity of aligning interests of involved departments; small volumes of involved patient groups; and inadequate information and communication technology (ICT) support. Third, project teams did not experience peer stimulus because they saw few similarities between their projects, rarely shared experiences, and did not demonstrate competitive behaviour. Besides, a number of project teams reported that organisational and external change agent support was limited. This study showed that the perceived need for tailoring standard change ideas to local contexts and the complexity of aligning interests of involved departments hampered the use of the QIC method for process redesign. We cannot determine whether the QIC method would have been appropriate for process redesign. Peer stimulus was non-optimal as a result of the selection process for participation of project teams by the external change agent. In conclusion, project teams felt that necessary preconditions for successful use of the QIC method were lacking.
TL;DR: Integrated Project Delivery (IPD) as mentioned in this paper aims to revamp AEC project outcomes through a collaborative method of regulating project stakeholders' goals through creation of a platform that provides early...
Abstract: Integrated Project Delivery (IPD) endeavour to revamp AEC project outcomes through a collaborative method of regulating project stakeholders’ goals through creation of a platform that provide early...