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Evaluating interventions to make healthcare safer: methodological analysis and case study

Benning, Amirta (2011)
Ph.D. thesis, University of Birmingham.

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Abstract

This thesis describes study designs for the robust evaluation of complex patient safety interventions. Fundamentally, study designs available to measure the effectiveness of patient safety interventions fall into two categories – those that use contemporaneous controls, and those that do not. A review of the recent literature (245 citations) revealed that most studies were single-centre (63%), and the majority of these did not use contemporaneous controls (84%); whilst in multi-centre studies (37%) the number of studies using contemporaneous controls (49%) equalled the number of studies that that did not (51%). Studies that do not use contemporaneous controls dominate the literature, but they are weak and subject to bias. The thesis further discussed a case-study, as an exemplar for the evaluation of a highly complex patient safety intervention – the Safer Patients Initiative (SPI), which sought to generically strengthen hospitals, whilst improving frontline activities. The evaluation was a before and after study, with contemporaneous controls. It used mixed-methods, so that the triangulation of a one type of research finding could be reinforced when corroborated by the finding of another type. Uniquely, it also, compared the rates of change across control and SPI hospitals – an approach referred to as the “difference-in-difference” method.

Type of Work:Ph.D. thesis.
Supervisor(s):Lilford, Richard J.
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Health and Population Sciences
Subjects:RA Public aspects of medicine
Institution:University of Birmingham
ID Code:1701
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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