Application of theory to enhance audit and feedback interventions to increase the uptake of evidence-based transfusion practice: an intervention development protocol

Implementation Science

Jill J Francis²  Jeremy M Grimshaw¹  Liz Glidewell⁶  Maria E Prior⁵  Susan Michie⁴  Simon J Stanworth³  Fabiana Lorencatto²  Natalie J Gould² 

[1] Faculty of Medicine, University of Ottawa, Ottawa, Canada;Centre for Health Services Research, City University London, London, UK;National Health Service Blood & Transplant, Oxford Radcliffe Hospitals, University of Oxford, Oxford, UK;Centre for Outcomes Research Effectiveness, University College London, London, UK;Health Services Research Unit, University of Aberdeen, Aberdeen, UK;Academic Unit of Primary Care, Leeds Institute of Health Sciences, Leeds, UK

关键词: Health professional behaviour change;    Study protocol;    Health services research;    Implementation;    Blood transfusion;    Audit and feedback;   

Others  :  1146869
DOI  :  10.1186/s13012-014-0092-1

 received in 2014-05-16, accepted in 2014-07-03,  发布年份 2014

【 摘 要 】

Background

Audits of blood transfusion demonstrate around 20% transfusions are outside national recommendations and guidelines. Audit and feedback is a widely used quality improvement intervention but effects on clinical practice are variable, suggesting potential for enhancement. Behavioural theory, theoretical frameworks of behaviour change and behaviour change techniques provide systematic processes to enhance intervention. This study is part of a larger programme of work to promote the uptake of evidence-based transfusion practice.

Objectives

The objectives of this study are to design two theoretically enhanced audit and feedback interventions; one focused on content and one on delivery, and investigate the feasibility and acceptability.

Methods

Study A (Content): A coding framework based on current evidence regarding audit and feedback, and behaviour change theory and frameworks will be developed and applied as part of a structured content analysis to specify the key components of existing feedback documents. Prototype feedback documents with enhanced content and also a protocol, describing principles for enhancing feedback content, will be developed. Study B (Delivery): Individual semi-structured interviews with healthcare professionals and observations of team meetings in four hospitals will be used to specify, and identify views about, current audit and feedback practice. Interviews will be based on a topic guide developed using the Theoretical Domains Framework and the Consolidated Framework for Implementation Research. Analysis of transcripts based on these frameworks will form the evidence base for developing a protocol describing an enhanced intervention that focuses on feedback delivery. Study C (Feasibility and Acceptability): Enhanced interventions will be piloted in four hospitals. Semi-structured interviews, questionnaires and observations will be used to assess feasibility and acceptability.

Discussion

This intervention development work reflects the UK Medical Research Council’s guidance on development of complex interventions, which emphasises the importance of a robust theoretical basis for intervention design and recommends systematic assessment of feasibility and acceptability prior to taking interventions to evaluation in a full-scale randomised study. The work-up includes specification of current practice so that, in the trials to be conducted later in this programme, there will be a clear distinction between the control (usual practice) conditions and the interventions to be evaluated.

【 授权许可】

   
2014 Gould et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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