PICOT question

11_Quality_Improvement_Project_fillable2.pdf

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© Copyright 2013‐2020, Helene Fuld Health Trust National Institute for Evidence‐based Practice in Nursing and Healthcare. Adapted with permission, from Evidence‐based practice in nursing and healthcare. (Appendix B; p. 539‐ 50), by Melnyk, Bernadette Mazurek, and Fineout‐Overholt, Ellen. Wolters Kluwer Health, 2015 and with permission, from Cincinnati Children’s Hospital Medical Center, Evidence‐based Decision Making Group: LEGEND system, 2006‐2013.

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Project title:

Date:

Reviewer(s) name(s):

PICOT Question:

Article citation (APA):

Indicate the level of the study you are appraising:

Recommendation for article inclusion in the body of evidence to answer your question:

1. Purpose of study/article/project:

1. Design/Method:

2. Sample:

3. Setting:

4. Data Collection:

RAPID CRITICAL APPRAISAL OF A QUALITY IMPROVEMENT PROJECT

PROJECT DESCRIPTION/LEVEL OF STUDY

GENERAL DESCRIPTION OF STUDY

OVERVIEW

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1. Was an improvement method clearly identified? Yes No Unknown  What was the improvement method?

PDSA Lean Process CQI TQM Six Sigma Other:___________________________

2. Was the need for improvement clearly described? Yes No Unknown  Was the current state of the process discussed? Yes No  Was the intended impact of improvement predicted and outlined? Yes No

3. Were the stakeholders and organizational culture clearly Yes No Unknown described?

 Were the stakeholders involved in decisions to make changes? Yes No (e.g. champions, supporters, early adapters, clinicians, care givers, patients, process owners)

4. Were the project methods clearly described and appropriate Yes No Unknown for the aim?

 Was the setting clearly described and appropriate (e.g. unit, clinic)? Yes No  Were the participants (e.g. clinicians, patients, groups) clearly described and appropriate? Yes No  Was the aim of the improvement project specific, measurable, actionable, Yes No

relevant, time bound (e.g. SMART)?

5. Was the planned improvement intervention (e.g. action plans) Yes No Unknown described in enough detail to be replicated?

QUALITY OF STUDY

VALIDITY: Are the results of this study valid?

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6. Were the planned improvement interventions based Yes No Unknown on evidence? External Evidence: Internal Evidence:

Published Research Failure Mode and Effects Analysis (analysis of causes of dysfunction) Published QI Reports Key Driver Analysis (Local Data) Benchmarks Pareto Analysis (Local Data) QI data (Local Data)

7. Were appropriate baseline data collected and reported for Yes No Unknown the outcome of interest?

 Did the baseline data indicate the need for improvement? Yes No  Were valid and reliable tools used for measurement of the outcome to be improved? Yes No

8. Was outcome data collection planned and appropriate to Yes No Unknown evaluate whether the QI project resulted in an improvement?

9. If adaptations/modifications were made to the planned Yes No Unknown improvement intervention, were they based on outcome data from small tests of change or pilot studied?

10. Were the modified improvement interventions (i.e. the future state of Yes No Unknown the process) described in enough detail to be replicated by others?

11. Was all outcome data for the improvement intervention(s) Yes No Unknown collected in the same way as the baseline data?

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12. Was there freedom from conflict of interest? Yes No Unknown  Sponsor/funding agency  Investigators

13. Was the date range of the cited literature current? Yes No Unknown  What date ranges were included? ?_____ to _____

o If older literature was included, why was it included?

14. Were the statistical analysis methods appropriate? Yes No Unknown

 What was the unit of analysis (e.g. clinician, clinician group, care area, process, etc.)?

 What was measured?

 Were the statistical analysis methods clearly described? Yes No  If multiple improvement interventions were used, was statistical analysis Yes No

conducted on each intervention?

15. What were the main results of the study?  Were results of the small tests of change or pilot studies reported? Yes No

 How large was the main improvement intervention effect?

 Statistical Significance (p value) __________  Confidence Interval and/or Standard Deviations __________  How precise was the intervention/treatment?

o Narrow? Wide? __________  Effect size __________

RELIABILITY: Are these valid study reports important?

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16. Were the results clinically significant? Yes No Unknown  Were the following reported: NNT, NNH, OR, RR? Yes No

17. Were the lessons learned discussed? Yes No Unknown  Were benefits/harms, costs, unexpected results, problems, or failures Yes No

reported or discussed?

18. Were the successful improvement interventions implemented Yes No Unknown with other clinicians or care groups (i.e. spread)?

19. Were the improvement interventions studied over a period of Yes No Unknown time long enough to determine sustainability (e.g. long term effects, attrition, institutionalization)?

20. Can the results be applied to my improvement issue of interest? Yes No Unknown  Is the treatment feasible in my care setting? Yes No  Do the outcomes apply to my population of interest? Yes No  Are the likely benefits worth the potential harm and costs? Yes No  Were the subjects/participants in this study similar to my population of interest? Yes No  Were all clinically important outcomes considered? Yes No

21. Will you include the article/study in your practice decision Yes No Unknown to make a difference in outcomes?

 If yes, why would you do this & how would you do this?  If no, why would you not include the results to make a difference?

APPLICABILITY/TRANSFERABILITY: Can I apply these valid, important study results?

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Level of evidence: I, II, III, IV, V, VI, VII (Select one)

Quality of evidence: High | Medium | Low (Select one)

What is the strength of the study/article?

What is your recommendation for article inclusion in the body of evidence to answer your question? Include this article in the body of evidence (place article on evaluation & synthesis tables) Do NOT include this article in the body of evidence

Additional Comments:

STRENGTH OF STUDY

STRENGTH = LEVEL + QUALITY

Copyright 20132018 The Helene Fuld Health Trust National Institute for Evidencebased Practice in Nursing and_6:
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Level of Study: [I]
Quality of Study: [Low]
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