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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