Irish quality improvement studies ‘demonstrate high reporting standards’ – RCSI study

A review by RCSI University of Medicine and Health Sciences in collaboration with the HSE National Quality Improvement Team has found that quality improvement (QI) studies in Ireland over a five-year period “conformed to high reporting standards and enhanced multiple elements of healthcare quality”.

The review showed an increasing trend in the frequency of publication of QI studies in Ireland, with 43 studies published during the period 2015 to 2020.

Key findings from the review published in BMJ Open Quality were that most QI studies were conducted in hospitals and aimed to improve the effectiveness (65 per cent), efficiency (53 per cent), timeliness (47 per cent) and safety (44 per cent) of care. Fewer aimed to improve patient-centredness (30 per cent), value for money (23 per cent) or staff well-being (9 per cent).

The review found that costs and healthcare outcomes were understudied and require increased attention to support better decision-making about resource allocation in healthcare. No study aimed to increase equity.

Dr Siobhán McCarthy, the study’s first author and Lecturer at the RCSI Graduate School of Healthcare Management, commented: “The review has, for the first time, profiled the characteristics of QI studies published in Ireland. It is encouraging to see that the studies meet high reporting standards with a focus on internationally recognised elements of healthcare quality.

“It is also pertinent that the review findings align with current international discussion about the need to promote equity-focussed quality improvement work.

“It is becoming increasingly acceptable to discuss costs in healthcare and the review points to an existing awareness of costs among QI practitioners in Ireland. Approximately half of studies discussed costs but did not quantify these sufficiently, highlighting the need to provide greater guidance to QI practitioners on performing cost analysis in healthcare.

“With appropriate educational guidance and resources, this awareness can be fine-tuned to support informative QI cost analyses.”

The study’s senior author and Director of the RCSI Healthcare Outcomes Research Centre, Prof Jan Sorensen, stated that “RCSI is committed to providing the evidence base to support better decision-making about resource allocation in healthcare, and we expect this study will guide healthcare educational institutions, researchers and policy makers to more substantially include consideration of costs and outcomes in QI studies.”

The study Reporting standards, outcomes and costs of quality improvement studies in Ireland: a scoping review was commissioned by the HSE.

It was conducted by Dr McCarthy of the Graduate School of Healthcare Management, Dr Samira Barbara Jabakhanji (post-doctoral researcher) and Prof Sorensen of the Healthcare Outcomes Research Centre at RCSI, in collaboration with Dr Jennifer Martin and Dr Maureen Flynn of the HSE National Quality Improvement Team.