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Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach

Overview of attention for article published in BMJ Open, September 2016
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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 (93rd percentile)

Mentioned by

news
1 news outlet
blogs
1 blog
twitter
93 tweeters
facebook
4 Facebook pages

Citations

dimensions_citation
5 Dimensions

Readers on

mendeley
28 Mendeley
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Title
Multimethod study of a large-scale programme to improve patient safety using a harm-free care approach
Published in
BMJ Open, September 2016
DOI 10.1136/bmjopen-2016-011886
Pubmed ID
Authors

Maxine Power, Liz Brewster, Gareth Parry, Ailsa Brotherton, Joel Minion, Piotr Ozieranski, Sarah McNicol, Abigail Harrison, Mary Dixon-Woods

Abstract

We aimed to evaluate whether a large-scale two-phase quality improvement programme achieved its aims and to characterise the influences on achievement. National Health Service (NHS) in England. NHS staff. The programme sought to (1) develop a shared national, regional and locally aligned safety focus for 4 high-cost, high volume harms; (2) establish a new measurement system based on a composite measure of 'harm-free' care and (3) deliver improved outcomes. Phase I involved a quality improvement collaborative intended to involve 100 organisations; phase II used financial incentives for data collection. Multimethod evaluation of the programme. In phase I, analysis of regional plans and of rates of data submission and clinical outcomes reported to the programme. A concurrent process evaluation was conducted of phase I, but only data on submission rates and clinical outcomes were available for phase II. A context of extreme policy-related structural turbulence impacted strongly on phase I. Most regions' plans did not demonstrate full alignment with the national programme; most fell short of recruitment targets and attrition in attendance at the collaborative meetings occurred over time. Though collaborative participants saw the principles underlying the programme as attractive, useful and innovative, they often struggled to convert enthusiasm into change. Developing the measurement system was arduous, yet continued to be met by controversy. Data submission rates remained patchy throughout phase I but improved in reach and consistency in phase II in response to financial incentives. Some evidence of improvement in clinical outcomes over time could be detected but was hard to interpret owing to variability in the denominators. These findings offer important lessons for large-scale improvement programmes, particularly when they seek to develop novel concepts and measures. External contexts may exert far-reaching influence. The challenges of developing measurement systems should not be underestimated.

Twitter Demographics

The data shown below were collected from the profiles of 93 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 28 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 4%
United States 1 4%
Unknown 26 93%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 21%
Student > Doctoral Student 3 11%
Student > Postgraduate 2 7%
Student > Master 2 7%
Lecturer > Senior Lecturer 2 7%
Other 8 29%
Unknown 5 18%
Readers by discipline Count As %
Medicine and Dentistry 9 32%
Social Sciences 4 14%
Nursing and Health Professions 4 14%
Business, Management and Accounting 1 4%
Unspecified 1 4%
Other 1 4%
Unknown 8 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 75. 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 08 April 2019.
All research outputs
#229,628
of 13,603,158 outputs
Outputs from BMJ Open
#474
of 12,092 outputs
Outputs of similar age
#8,834
of 265,498 outputs
Outputs of similar age from BMJ Open
#28
of 432 outputs
Altmetric has tracked 13,603,158 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 12,092 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.8. This one has done particularly well, scoring higher than 96% 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 265,498 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 432 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 93% of its contemporaries.