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To evaluate the effectiveness of the recommendation improvement matrix (RIM) methodology for improving the quality of recommendations resulting from sentinel event analysis, where we hypothesise that the use of the RIM methodology leads to better quality recommendations.
A before-and-after analysis of the quality of the formulated recommendations after sentinel event analysis.
The study was carried out during the 2023 Saudi Patient Safety Centre International Patient Safety Conference.
36 conference participants, including nurses, medical doctors, pharmacists, dentists, general practitioners and quality officers.
RIM methodology training during a structured 3-hour workshop.
The primary outcome was the proportion of recommendations that using the 2 test, passed the RIM filter criteria before and after training. Secondary outcomes included changes in recommendation categorisation within the matrix and participant ratings of feasibility and usability on a five-point Likert scale using a t-test for comparison.
Prior to training, 49 recommendations were generated, of which 63.3% met the filter criteria. Post-training, the proportion of recommendations passing the filter increased significantly to 83% (p=0.00543). Adjustments to recommendations primarily improved alignment with the filter criteria, though limited improvements were observed in matrix categorisation. Participants rated the methodology’s feasibility and usability highly, with average scores of 4.39/5 and 4.43/5, respectively. However, 46% expressed a need for additional training, particularly on the matrix application.
The RIM methodology significantly improves the quality of recommendations following sentinel event analyses. To enhance its impact, further training focusing on matrix application is necessary. Incorporating the methodology into healthcare education and professional development could strengthen patient safety practices.
To explore how coaching can facilitate the development of an Evidence-Based Quality Improvement (EBQI) learning culture within nursing teams in hospital and community care settings. This study also explores the specific contextual factors that influence effective outcomes.
Action research.
Nine teams, including 254 nurses were selected from four hospitals and two community care organisations to participate in the development of an EBQI-learning culture under the guidance of internal and external coaches. Data were gathered from 27 focus groups with 56 unique participants (of whom 31 participated multiple times) and six individual interviews with three external coaches. Transcripts of all interviews were subjected to abductive thematic analysis.
To promote an EBQI learning culture in nursing teams, it is essential that internal coaches effectively guide their team members. The internal coaches in this study focused on enhancing readiness for EBQI by providing support, encouraging involvement and motivating team members. They deepened innovation competencies including assessing daily care, implementing well-structured changes in care practices and embedding small steps in the change process in daily routines. It was found that barriers and facilitators within the team's context can influence the development of EBQI-learning culture and therefore need to be considered when seeking to make changes. The presence of external coaches served as a valuable resource and a motivator in supporting internal coaches to apply and improve their coaching skills.
To stimulate the development of an EBQI-learning culture, internal coaches need to focus on team readiness to work with EBQI. Priority needs to be given to enhancing the care change competencies of team members. Barriers to change must also be addressed. Internal coaches require external support and motivation to continually develop coaching skills.
The Standards for Reporting Qualitative Research.
No patient or public contribution.
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