Improving adherence to guideline recommendations in dementia care through establishing a quality improvement collaborati
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(2020) 1:80
Implementation Science Communications
RESEARCH
Open Access
Improving adherence to guideline recommendations in dementia care through establishing a quality improvement collaborative of agents of change: an interrupted time series study Kate Laver1,2* , Monica Cations1,2, Gorjana Radisic1,2, Lenore de la Perrelle1,2, Richard Woodman1, Janna Anneke Fitzgerald2,3, Susan Kurrle2,4, Ian D. Cameron2,4, Craig Whitehead1,2, Jane Thompson2, Billingsley Kaambwa1, Kate Hayes2,3 and Maria Crotty1,2
Abstract Background: Non-pharmacological interventions including physical activity programmes, occupational therapy and caregiver education programmes have been shown to lead to better outcomes for people with dementia and their care partners. Yet, there are gaps between what is recommended in guidelines and what happens in practice. The aim of this study was to bring together clinicians working in dementia care and establish a quality improvement collaborative. The aim of the quality improvement collaborative was to increase self-reported guideline adherence to three guideline recommendations. Methods: Interrupted time series. We recruited health professionals from community, hospital and aged care settings across Australia to join the collaborative. Members of the collaborative participated in a start-up meeting, completed an online learning course with clinical and quality improvement content, formed a quality improvement plan which was reviewed by a team of experts, received feedback following an audit of their current practice and were able to share experiences with their peers. The primary outcome was self-reported adherence to their guideline recommendation of interest which was measured using checklists. Data were collected monthly over a period of 18 months, and the study used an interrupted time series design and multilevel Poisson regression analysis to evaluate changes in self-reported adherence. Results: A total of 45 health professionals (78% therapists) from different sites joined the collaborative and 28 completed all requirements. Data from 1717 checklists were included in the analyses. Over the duration of the project, there was a significant increase in clinician self-reported adherence to guideline recommendations with a 42.1% immediate increase in adherence (incidence rate ratio = 1.42; 95% confidence interval = 1.08–1.87; p = 0.012). (Continued on next page)
* Correspondence: [email protected] 1 College of Medicine and Public Health, Flinders University, Adelaide, Australia 2 NHMRC Cognitive Decline Partnership Centre, Sydney, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The
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