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Table 2 Factors influencing use of data for local QI

From: A scoping review of local quality improvement using data from UK perioperative National Clinical Audits

Micro level
Barriers Enablers
Lack of time and resources Perceived need to improve from low baseline performance
Lack of QI experience Embedding data collection into normal practice
Extra data collection needed in addition to NCA data Multi-faceted approach to data feedback
Lack of awareness of scale of local problems Leverage of existing networks to disseminate data
Difficulty communicating and collaborating across diverse groups of stakeholders Use of patients as a ‘technology of persuasion’
Challenges overturning embedded practices Enthusiasm for QI project
Rotational shift patterns of clinical staff threaten sustainability of projects  
Meso level
Barriers Enablers
Challenges collecting data Supportive digital context
Difficulties accessing existing data Effective collaboration between managers and clinicians
Difficulties engaging ‘peripheral’ (but important) staff groups like IT or pathology QI seen as part of normal practice
Lack of incentivisation for clinical staff to perform QI Sense of community amongst healthcare professionals
Challenges integrating multidisciplinary teams Avoidance of blame culture
Macro level
Barriers Enablers
Challenges regarding data validity/timeliness/completeness Valid and timely data feedback*
Unconvincing evidence base for improvement Productive collaborations between hospitals*
Disputed processes of case-mix adjustment Facilitated sharing of best practice between sites*
Lack of clear actions for improvement provided by NCAs Central provision of data analytical/visualisation tools*
NCA reports inaccessible to managers/commissioners Evidence base perceived as strong*
NCA data insufficient for local needs National performance perceived as weak or variable*
Financial incentives (e.g. best practice tariffs)
Relevant and concise reports
Regulatory/professional pressures to involve patients/public can motivate PROM/PREM collection and use
  1. * denotes factors describing the two NCAs (NHFD and NELA) whose data were most frequently used for local QI