Despite criticisms that many quality improvement (QI) initiatives fail due to incomplete programme theory, there is no defined way to evaluate how programme theory has been articulated. The objective of this research was to develop, and assess the usability and reliability of scoring criteria to evaluate programme theory diagrams.
Criteria development was informed by published literature and QI experts. Inter-rater reliability was tested between two evaluators. About 63 programme theory diagrams (42 driver diagrams and 21 action–effect diagrams) were reviewed to establish whether the criteria could support comparative analysis of different approaches to constructing diagrams.
Components of the scoring criteria include: assessment of overall aim, logical overview, clarity of components, cause–effect relationships, evidence and measurement. Independent reviewers had 78% inter-rater reliability. Scoring enabled direct comparison of different approaches to developing programme theory; action–effect diagrams were found to have had a statistically significant but moderate improvement in programme theory quality over driver diagrams; no significant differences were observed based on the setting in which driver diagrams were developed.
The scoring criteria summarise the necessary components of programme theory that are thought to contribute to successful QI projects. The viability of the scoring criteria for practical application was demonstrated. Future uses include assessment of individual programme theory diagrams and comparison of different approaches (e.g. methodological, teaching or other QI support) to produce programme theory. The criteria can be used as a tool to guide the production of better programme theory diagrams, and also highlights where additional support for QI teams could be needed.
Laurel Issen, Thomas Woodcock, Christopher McNicholas, Laura Lennox, Julie E Reed; Criteria for evaluating programme theory diagrams in quality improvement initiatives: a structured method for appraisal, International Journal for Quality in Health Care, Volume 30, Issue 7, 1 August 2018, Pages 508–513, https://doi.org/10.1093/intqhc/mzy063
You might also like...
Invitation to tender
The deadline for responses is 12.00 on Tuesday 5 November 2019.
Research shows 88% of autistic people do not think their needs are understood by health professionals. Emily Niner and Oliver...
…we need to pass our knowledge on to drive forward policy and practice. Here's what the Health Foundation is doing.
Health Foundation @HealthFdn
Have you read our briefing on people's long-term condition #selfmanagement and their use of health care? Our resea… https://t.co/kS5Elymt9aFollow us on Twitter
Work with us
We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.View current vacancies
The Q Community
Q is an initiative connecting people with improvement expertise across the UK.Find out more