Skip to main content
Top
Published in: Human Resources for Health 1/2020

Open Access 01-12-2020 | Birth | Review

Virtual adaptation of traditional healthcare quality improvement training in response to COVID-19: a rapid narrative review

Authors: Zuneera Khurshid, Aoife De Brún, Gemma Moore, Eilish McAuliffe

Published in: Human Resources for Health | Issue 1/2020

Login to get access

Abstract

Background

Information and communication technology are playing a major role in ensuring continuity of healthcare services during the COVID-19 pandemic. The pandemic has also disrupted healthcare quality improvement (QI) training and education for healthcare professionals and there is a need to rethink the way QI training and education is delivered. The purpose of this rapid evidence review is to quickly, but comprehensively collate studies to identify what works and what does not in delivering QI training and education using distance learning modalities.

Methods

Three healthcare databases were searched along with grey literature sources for studies published between 2015 and 2020. Studies with QI training programmes or courses targeting healthcare professionals and students with at least one component of the programme being delivered online were included.

Results

A total of 19 studies were included in the review. Most studies had a mixed methods design and used blended learning methods, combining online and in-person delivery modes. Most of the included studies reported achieving desired outcomes, including improved QI knowledge, skills and attitudes of participants and improved clinical outcomes for patients. Some benefits of online QI training delivery include fewer required resources, reduced need for on-site instructors, increased programme reach, and more control and flexibility over learning time for participants. Some limitations of online delivery modes include limited learning and networking opportunities, functional and technical problems and long lead time for content adaptation and customisation.

Discussion

The review highlights that distance learning approaches to QI help in overcoming barriers to traditional QI training. Some important considerations for those looking to adapt traditional programmes to virtual environments include balancing virtual and non-virtual methods, using suitable technological solutions, customising coaching support, and using multiple criteria for programme evaluation.

Conclusion

Virtual QI and training of healthcare professionals and students is a viable, efficient, and effective alternative to traditional QI education that will play a vital role in building their competence and confidence to improve the healthcare system in post-COVID environment.
Appendix
Available only for authorised users
Literature
3.
go back to reference Clarke MJ, Steffens FL, Mallory GW, Starr SR, Porter BL, Krauss WE, Dankbar EC. Incorporating quality improvement into resident education: structured curriculum, evaluation, and quality improvement projects. World Neurosurg. 2019;126:e1112–20.CrossRef Clarke MJ, Steffens FL, Mallory GW, Starr SR, Porter BL, Krauss WE, Dankbar EC. Incorporating quality improvement into resident education: structured curriculum, evaluation, and quality improvement projects. World Neurosurg. 2019;126:e1112–20.CrossRef
5.
go back to reference Ewins E, Macpherson R, van der Linden G, Arnott S. Training in quality improvement for the next generation of psychiatrists. BJPsych Bull. 2017;41:45–50.CrossRef Ewins E, Macpherson R, van der Linden G, Arnott S. Training in quality improvement for the next generation of psychiatrists. BJPsych Bull. 2017;41:45–50.CrossRef
6.
go back to reference Herman DD, Weiss CH, Thomson CC. Educational strategies for training in quality improvement and implementation medicine. ATS Scholar. 2020;1:20–32.CrossRef Herman DD, Weiss CH, Thomson CC. Educational strategies for training in quality improvement and implementation medicine. ATS Scholar. 2020;1:20–32.CrossRef
7.
go back to reference Rose S. Medical student education in the time of COVID-19. JAMA. 2020;323:2131–2.CrossRef Rose S. Medical student education in the time of COVID-19. JAMA. 2020;323:2131–2.CrossRef
8.
go back to reference Kanneganti A, Lim KMX, Chan GMF, Choo S-N, Choolani M, Ismail-Pratt I, Logan SJS. Pedagogy in a pandemic—COVID-19 and virtual continuing medical education (vCME) in obstetrics and gynecology. Acta Obstet Gynecol Scand. 2020;99:692–5.CrossRef Kanneganti A, Lim KMX, Chan GMF, Choo S-N, Choolani M, Ismail-Pratt I, Logan SJS. Pedagogy in a pandemic—COVID-19 and virtual continuing medical education (vCME) in obstetrics and gynecology. Acta Obstet Gynecol Scand. 2020;99:692–5.CrossRef
9.
go back to reference Grainger R, Liu Q, Geertshuis S. Learning technologies: a medium for the transformation of medical education? Med Educ. 2020;00:1–7. Grainger R, Liu Q, Geertshuis S. Learning technologies: a medium for the transformation of medical education? Med Educ. 2020;00:1–7.
10.
go back to reference Mehta R, Sharma KA. Use of learning platforms for quality improvement. Indian Pediatr. 2018;55:803–8.CrossRef Mehta R, Sharma KA. Use of learning platforms for quality improvement. Indian Pediatr. 2018;55:803–8.CrossRef
11.
go back to reference Suliman S, Hassan R, Athamneh K, Jenkins M, Bylund C. Blended learning in quality improvement training for healthcare professionals in Qatar. Int J Med Educ. 2018;9:55–6.CrossRef Suliman S, Hassan R, Athamneh K, Jenkins M, Bylund C. Blended learning in quality improvement training for healthcare professionals in Qatar. Int J Med Educ. 2018;9:55–6.CrossRef
12.
go back to reference Noble H, Smith J. Reviewing the literature: choosing a review design. Evid Based Nurs. 2018;21:39.CrossRef Noble H, Smith J. Reviewing the literature: choosing a review design. Evid Based Nurs. 2018;21:39.CrossRef
13.
go back to reference Rubenstein LV, Hempel S, Liu JL, Danz MJ, Foy R, Lim Y-W, Motala A, Shekelle PG. The Minimum Quality Criteria Set (QI-MQCS) for critical appraisal: advancing the science of quality improvement. Implem Sci. 2015;10:A19–A19.CrossRef Rubenstein LV, Hempel S, Liu JL, Danz MJ, Foy R, Lim Y-W, Motala A, Shekelle PG. The Minimum Quality Criteria Set (QI-MQCS) for critical appraisal: advancing the science of quality improvement. Implem Sci. 2015;10:A19–A19.CrossRef
14.
go back to reference Baernholdt M, Feldman M, Davis-Ajami ML, Harvey LD, Mazmanian PE, Mobley D, Murphy JK, Watts C, Dow A. An interprofessional quality improvement training program that improves educational and quality outcomes. Am J Med Qual. 2019;34:577–84.CrossRef Baernholdt M, Feldman M, Davis-Ajami ML, Harvey LD, Mazmanian PE, Mobley D, Murphy JK, Watts C, Dow A. An interprofessional quality improvement training program that improves educational and quality outcomes. Am J Med Qual. 2019;34:577–84.CrossRef
15.
go back to reference Baxley EG, Lawson L, Garrison HG, Walsh D, Lazorick S, Lake D, Higginson J. The teachers of quality academy: a learning community approach to preparing faculty to teach health systems science. Acad Med. 2016;91:1655–60.CrossRef Baxley EG, Lawson L, Garrison HG, Walsh D, Lazorick S, Lake D, Higginson J. The teachers of quality academy: a learning community approach to preparing faculty to teach health systems science. Acad Med. 2016;91:1655–60.CrossRef
16.
go back to reference Bonnes SL, Ratelle JT, Halvorsen AJ, Carter KJ, Hafdahl LT, Wang AT, Mandrekar JN, Oxentenko AS, Beckman TJ, Wittich CM. Flipping the quality improvement classroom in residency education. Acad Med. 2017;92:101–7.CrossRef Bonnes SL, Ratelle JT, Halvorsen AJ, Carter KJ, Hafdahl LT, Wang AT, Mandrekar JN, Oxentenko AS, Beckman TJ, Wittich CM. Flipping the quality improvement classroom in residency education. Acad Med. 2017;92:101–7.CrossRef
17.
go back to reference Gregory ME, Bryan JL, Hysong SJ, Kusters IS, Miltner RS, Stewart DE, Polacek N, Woodard LD, Anderson J, Naik AD, Godwin KM. Evaluation of a distance learning curriculum for interprofessional quality improvement leaders. Am J Med Qual. 2018;33:590–7.CrossRef Gregory ME, Bryan JL, Hysong SJ, Kusters IS, Miltner RS, Stewart DE, Polacek N, Woodard LD, Anderson J, Naik AD, Godwin KM. Evaluation of a distance learning curriculum for interprofessional quality improvement leaders. Am J Med Qual. 2018;33:590–7.CrossRef
18.
go back to reference Hafford-Letchfield T, Dayananda A, Collins D. Digital storytelling for interprofessional collaborative practice to develop quality and service improvements. Soc Work Educ. 2018;37:804–12.CrossRef Hafford-Letchfield T, Dayananda A, Collins D. Digital storytelling for interprofessional collaborative practice to develop quality and service improvements. Soc Work Educ. 2018;37:804–12.CrossRef
19.
go back to reference Hargreaves MB, Orfield C, Honeycutt T, Vine M, Cabili C, Coffee-Borden B, Morzuch M, Lebrun-Harris LA, Fisher SK. Addressing childhood obesity through multisector collaborations: evaluation of a national quality improvement effort. J Community Health. 2017;42:656–63.CrossRef Hargreaves MB, Orfield C, Honeycutt T, Vine M, Cabili C, Coffee-Borden B, Morzuch M, Lebrun-Harris LA, Fisher SK. Addressing childhood obesity through multisector collaborations: evaluation of a national quality improvement effort. J Community Health. 2017;42:656–63.CrossRef
20.
go back to reference Jamal N. Patient safety and quality improvement education in otolaryngology residency: preliminary look at a module-based approach. OTO Open. 2017;1:2473974x17698647.CrossRef Jamal N. Patient safety and quality improvement education in otolaryngology residency: preliminary look at a module-based approach. OTO Open. 2017;1:2473974x17698647.CrossRef
21.
go back to reference Keefer P, Orringer K, Vredeveld J, Warrier K, Burrows H. Developing a quality improvement and patient safety toolbox: the curriculum. MedEdPORTAL. 2016;12:10385. Keefer P, Orringer K, Vredeveld J, Warrier K, Burrows H. Developing a quality improvement and patient safety toolbox: the curriculum. MedEdPORTAL. 2016;12:10385.
22.
go back to reference Kennedy DR, Boren SA, Kapp JM, Simoes EJ. Building and launching an online quality improvement information exchange for home visiting programs in Missouri. Online J Public Health Inform. 2017;9:e189.CrossRef Kennedy DR, Boren SA, Kapp JM, Simoes EJ. Building and launching an online quality improvement information exchange for home visiting programs in Missouri. Online J Public Health Inform. 2017;9:e189.CrossRef
23.
go back to reference Maxwell KL, Wright VH. Evaluating the effectiveness of two teaching strategies to improve nursing students’ knowledge, skills, and attitudes about quality improvement and patient safety. Nurs Educ Perspect. 2016;37:291–2.CrossRef Maxwell KL, Wright VH. Evaluating the effectiveness of two teaching strategies to improve nursing students’ knowledge, skills, and attitudes about quality improvement and patient safety. Nurs Educ Perspect. 2016;37:291–2.CrossRef
24.
go back to reference Potts S, Shields S, Upshur C. Preparing future leaders: an integrated quality improvement residency curriculum. Fam Med. 2016;48:477–81. Potts S, Shields S, Upshur C. Preparing future leaders: an integrated quality improvement residency curriculum. Fam Med. 2016;48:477–81.
25.
go back to reference Ramar K, Hale CW, Dankbar EC. Innovative model of delivering quality improvement education for trainees—a pilot project. Med Educ Online. 2015;20:28764.CrossRef Ramar K, Hale CW, Dankbar EC. Innovative model of delivering quality improvement education for trainees—a pilot project. Med Educ Online. 2015;20:28764.CrossRef
26.
go back to reference Scales CD, Moin T, Fink A, Berry SH, Afsar-Manesh N, Mangione CM, Kerfoot BP. A randomized, controlled trial of team-based competition to increase learner participation in quality-improvement education. Int J Qual Health Care. 2016;28:227–32.CrossRef Scales CD, Moin T, Fink A, Berry SH, Afsar-Manesh N, Mangione CM, Kerfoot BP. A randomized, controlled trial of team-based competition to increase learner participation in quality-improvement education. Int J Qual Health Care. 2016;28:227–32.CrossRef
27.
go back to reference Shaikh U, Afsar-manesh N, Amin AN, Clay B, Ranji SR. Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California. Int J Qual Health Care. 2017;29:735–9.CrossRef Shaikh U, Afsar-manesh N, Amin AN, Clay B, Ranji SR. Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California. Int J Qual Health Care. 2017;29:735–9.CrossRef
28.
go back to reference Shelgikar AV, Priddy C, Harrison RV. Meeting ACGME and ABMS quality improvement requirements in a sleep medicine fellowship program. J Clin Sleep Med. 2017;13:1177–83.CrossRef Shelgikar AV, Priddy C, Harrison RV. Meeting ACGME and ABMS quality improvement requirements in a sleep medicine fellowship program. J Clin Sleep Med. 2017;13:1177–83.CrossRef
29.
go back to reference Sorita A, Raslau D, Murad MH, Steffen MW. Teaching quality improvement in occupational medicine: improving the efficiency of medical evaluation for commercial drivers. J Occup Environ Med. 2015;57:453–8.CrossRef Sorita A, Raslau D, Murad MH, Steffen MW. Teaching quality improvement in occupational medicine: improving the efficiency of medical evaluation for commercial drivers. J Occup Environ Med. 2015;57:453–8.CrossRef
30.
go back to reference Tappen RM, Newman D, Huckfeldt P, Yang Z, Engstrom G, Wolf DG, Shutes J, Rojido C, Ouslander JG. Evaluation of nursing facility resident safety during implementation of the INTERACT quality improvement program. J Am Med Dir Assoc. 2018;19(907–913):e901. Tappen RM, Newman D, Huckfeldt P, Yang Z, Engstrom G, Wolf DG, Shutes J, Rojido C, Ouslander JG. Evaluation of nursing facility resident safety during implementation of the INTERACT quality improvement program. J Am Med Dir Assoc. 2018;19(907–913):e901.
31.
go back to reference Tartaglia KM, Walker C. Effectiveness of a quality improvement curriculum for medical students. Med Educ Online. 2015;20(1):27133.CrossRef Tartaglia KM, Walker C. Effectiveness of a quality improvement curriculum for medical students. Med Educ Online. 2015;20(1):27133.CrossRef
32.
go back to reference Zubkoff L, Neily J, Delanko V, Young-Xu Y, Boar S, Bulat T, Mills PD. How to prevent falls and fall-related injuries: a virtual breakthrough series collaborative in long term care. Phys Occup Ther Geriatr. 2019;37:234–46.CrossRef Zubkoff L, Neily J, Delanko V, Young-Xu Y, Boar S, Bulat T, Mills PD. How to prevent falls and fall-related injuries: a virtual breakthrough series collaborative in long term care. Phys Occup Ther Geriatr. 2019;37:234–46.CrossRef
33.
go back to reference Sullivan LG: A systematic review to compare the effectiveness of face-to-face versus online (including blended learning) delivery of CME/CPD for healthcare practitioners (HCPs). 2017. Sullivan LG: A systematic review to compare the effectiveness of face-to-face versus online (including blended learning) delivery of CME/CPD for healthcare practitioners (HCPs). 2017.
34.
go back to reference Kirkpatrick DL. Techniques for evaluation training programs. J Am Soc Train Dir. 1959;13:21–6. Kirkpatrick DL. Techniques for evaluation training programs. J Am Soc Train Dir. 1959;13:21–6.
35.
go back to reference Chaudhuri JD. Stimulating intrinsic motivation in millennial students: a new generation, a new approach. Anat Sci Educ. 2020;13:250–71.CrossRef Chaudhuri JD. Stimulating intrinsic motivation in millennial students: a new generation, a new approach. Anat Sci Educ. 2020;13:250–71.CrossRef
36.
go back to reference Tsuei SH-T, Lee D, Ho C, Regehr G, Nimmon L. Exploring the construct of psychological safety in medical education. In: 11S association of American medical colleges learn serve lead: Proceedings of the 58th annual research in medical education sessions, vol. 94. Academic Medicine; 2019. pp. S28–35. Tsuei SH-T, Lee D, Ho C, Regehr G, Nimmon L. Exploring the construct of psychological safety in medical education. In: 11S association of American medical colleges learn serve lead: Proceedings of the 58th annual research in medical education sessions, vol. 94. Academic Medicine; 2019. pp. S28–35.
37.
go back to reference Greenhalgh T, Thorne S, Malterud K. Time to challenge the spurious hierarchy of systematic over narrative reviews? Eur J Clin Invest. 2018;48:e12931.CrossRef Greenhalgh T, Thorne S, Malterud K. Time to challenge the spurious hierarchy of systematic over narrative reviews? Eur J Clin Invest. 2018;48:e12931.CrossRef
Metadata
Title
Virtual adaptation of traditional healthcare quality improvement training in response to COVID-19: a rapid narrative review
Authors
Zuneera Khurshid
Aoife De Brún
Gemma Moore
Eilish McAuliffe
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Birth
COVID-19
Published in
Human Resources for Health / Issue 1/2020
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-020-00527-2

Other articles of this Issue 1/2020

Human Resources for Health 1/2020 Go to the issue