↓ Skip to main content

Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people

Overview of attention for article published in BMJ Open, August 2016
Altmetric Badge

About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

Mentioned by

twitter
103 tweeters

Citations

dimensions_citation
6 Dimensions

Readers on

mendeley
38 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Ethnographic process evaluation of a quality improvement project to improve transitions of care for older people
Published in
BMJ Open, August 2016
DOI 10.1136/bmjopen-2015-010988
Pubmed ID
Authors

Elizabeth Sutton, Mary Dixon-Woods, Carolyn Tarrant

Abstract

Quality improvement projects to address transitions of care across care boundaries are increasingly common but meet with mixed success for reasons that are poorly understood. We aimed to characterise challenges in a project to improve transitions for older people between hospital and care homes. Independent process evaluation, using ethnographic observations and interviews, of a quality improvement project. An English hospital and two residential care homes for older people. 32 hours of non-participant observations and 12 semistructured interviews with project members, hospital and care home staff. A hospital-based improvement team sought to reduce unplanned readmissions from residential care homes using interventions including a community-based geriatric team that could be accessed directly by care homes and a communication tool intended to facilitate transfer of information between homes and hospital. Only very modest (if any) impacts of these interventions on readmission rates could be detected. The process evaluation identified multiple challenges in implementing interventions and securing improvement. Many of these arose because of lack of consensus on the nature of the problem and the proper solutions: while the hospital team was keen to reduce readmissions and saw the problems as lying in poor communication and lack of community-based support for care homes, the care home staff had different priorities. Care home staff were unconvinced that the improvement interventions were aligned with their needs or addressed their concerns, resulting in compromised implementation. Process evaluations have a valuable role in quality improvement. Our study suggests that a key task for quality improvement projects aimed at transitions of care is that of developing a shared view of the problem to be addressed. A more participatory approach could help to surface assumptions, interpretations and interests and could facilitate the coproduction of solutions. This finding is likely to have broader applicability.

Twitter Demographics

The data shown below were collected from the profiles of 103 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 38 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 3%
United States 1 3%
Unknown 36 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 8 21%
Unspecified 6 16%
Student > Master 5 13%
Student > Ph. D. Student 5 13%
Other 4 11%
Other 10 26%
Readers by discipline Count As %
Medicine and Dentistry 11 29%
Unspecified 10 26%
Social Sciences 10 26%
Nursing and Health Professions 4 11%
Decision Sciences 1 3%
Other 2 5%

Attention Score in Context

This research output has an Altmetric Attention Score of 61. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 May 2019.
All research outputs
#296,241
of 13,898,656 outputs
Outputs from BMJ Open
#618
of 12,563 outputs
Outputs of similar age
#10,107
of 264,460 outputs
Outputs of similar age from BMJ Open
#19
of 401 outputs
Altmetric has tracked 13,898,656 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 12,563 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.9. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 264,460 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 401 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.