Evaluation of IC5

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Evaluation of IC5

• IC5 Quality Congress
• November 18, 2005
• Gary F. Teare PhD
• Hospital Report Research Collaborative

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IC5Collaborative Quality Improvement in Complex
Continuing Care

• First time for such a large-scale quality
  improvement initiative in CCC
• Goal to improve continence care in CCC by
  introducing an evidence-based model of care and
  facilitating collaboration on improvement
• Focus Quality improvement not research
• However

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Evaluation of IC5

• Important to evaluate IC5 because
• Learn from our experience to improve the
  effectiveness of future collaboratives
• Share widely the experience, challenges and
  successes of this improvement effort
• Contribute to a small but growing research
  literature on the effectiveness of Improvement
  Collaboratives
• Evidence base helps establishment of future
  collaborative improvement work

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Evaluation Questions

• Was the Collaborative effective in stimulating
  improvement in ?
• Processes of continence care in CCC programs
• Continence outcomes for CCC patients
• What factors (organization, team, individuals,
  interventions) led to or hindered success?
• What are the costs () of the Collaborative
  improvement method ?

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Guiding Model

• Organizational Context
• Size/resources of CCC program
• Characteristics of patients
• Knowledge/Attitudes/Beliefs of staff

• Care Processes
• Assessment
• Interventions

• Care Systems
• Tools
• Expertise
• Improvement
• teams

• Patient Outcomes
• Increased continence
• (less decline of continence)
• Improved use of catheters
• Improved use of incont.
• products

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Evaluation Plan

• Pre Post Comparison in participating hospitals
• Knowledge, attitudes and beliefs concerning
  incontinence in CCC patients
• Implementation of Model of Excellence in
  Continence Care
• Incontinence assessment practices
• Continence-promoting interventions
• Incontinence management practices
• Patient outcomes
• Incontinent ? continent fewer with declining
  continence
• Patients with indwelling catheters
• Patients own continence goals recorded and met

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Evaluation Plan

• Comparison to non-participating hospitals
• Same dimensions as pre-post within hospital
  comparisons
• Allows interpretation of changes seen at
  participating hospitals to be more directly
  connected to IC5

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Measurement

• Over-riding concern
• Keep data collection burden as low as possible
  dont distract from IMPROVEMENT work

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Measurement Primary Data

• Surveys
• Knowledge, Attitudes and Beliefs
• IC5 improvement team functioning
• Staff perception of organizations orientation to
  improvement
• Summary of IC5 activities, changes and impacts
• Chart abstractions
• Presence and content of continence assessment
• Treatment plans components of Model of
  Excellence
• Patient/family involvement and information
• Catheter use (reason, size, patient/family
  involvement)

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Measurement Existing Data

• Minimum Data Set
• Decrease in bladder continence
• Indwelling catheter use
• Descriptive characteristics of CCC patient
  populations
• Hospital Report System Integration and Change
  survey
• Hospital structures to support quality
• Special section on Continence care

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So How did it go?

• Were in the middle of data collection for most
  of our measures
• Some of the existing data will not be available
  for several months
• Some early results from some of the surveys
  received so far

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Which IC5 Components Seemed Most Helpful?
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Which IC5 Components Seemed Most Helpful?
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IC5 by the Numbers ImpactResults from currently
available data from 4 of the 12 hospitals
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More to come

• Watch www.hospitalreport.ca/IC 5.html
• Spring 2006 for results of surveys and chart
  audits
• Fall/Winter 2006 for MDS-based results