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Crossing the Global Quality Chasm: Improving Health Care Worldwide (2018)

Chapter:Appendix B: Methods for Rapid Review

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Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
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B

Methods for Rapid Review

OBJECTIVE

The objective of this rapid review was to accumulate evidence on strategies being used by governments and insurers to improve health care quality.

Types of Studies Included

  • Randomized controlled trials (RCTs), including cluster randomized controlled trials (CRCTs)
  • Quasirandomized trials (QRTs), including cluster quasirandomized trials (ClQ-RCTs) using methods of allocation such as alternation or allocation by case note number
  • Observational designs with a comparison group, such as cohort or case-control designs (cross-sectional designs excluded)
  • Case series in which a comparison can be made before and after the implementation of a strategy

Types of Participants: Patients, health care consumers, and health care providers, including organizations (e.g., hospitals, practices, and individual health care professionals), without any restriction by type of health care professional, provider, setting, or purchaser.

Types of Outcome Measures: Primary: Improvement in a quality-of-care metric (i.e., safety, effectiveness, timeliness, patient-centeredness, equity, or efficiency) at any follow-up time.

Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
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SEARCH STRATEGY AND DATABASES USED

All terms within Table B-1 below were searched with an OR command between them, while terms across columns were searched with an AND command between them. The search was first conducted with terms from all columns being used. A secondary search was then conducted with column D excluded, and all duplicates were deleted.

TABLE B-1 Search Strategy

Databases: Scopus, Web of Science, Medline (Ovid), Embase (Ovid), and Pubmed
A B C D
All low- and middle-income countries as identified by the World Bank
  • “health system”
  • “health care”
  • “health care delivery”
  • “health care services”
  • “provider network”
  • “empanelment”
  • “prior authorization”
  • “pay for performance”
  • “performance-based financing”
  • “clinical audits”
  • “death audits”
  • “accreditation”
  • “inspection”
  • “licensing”
  • “safety standards”
  • “minimum quality”
  • “safety protocol”
  • “quality improvement protocol”
  • “clinical decision support”
  • “public reporting”
  • “shared decision making”
  • “provider reimbursement”
  • “results based financing”
  • “selective contracting”
  • “strategic contracting”
  • “strategic purchasing”
  • “purchaser strategies”
  • “healthcare quality”
  • “health care quality”
  • “quality improvement”

NOTE: The search terms were developed based on an initial reading of the literature and feedback from the committee.

Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×
Image
FIGURE B-1 Article exclusion flow chart.

DATA COLLECTION AND ANALYSIS

Selection of Studies

All titles and abstracts were downloaded into Excel. Articles were excluded in three phases: title review, abstract review, and document review. One reviewer conducted the title review. Two reviewers conducted the abstract review. Articles included for document review were the combination of those abstracts deemed eligible for inclusion. Multiple reviewers then conducted the last phase as articles were read for content.

Data Management

In the final phase of document review, all papers were categorized to streamline synthesis of data. Fourteen categories were identified: accreditation, conditional cash transfers, community engagement, public report, payment reform (general), workforce training, clinical monitoring and

Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×

auditing, care coordination, clinical decision support, pay for performance, mHealth, quality improvement (general), strategic purchasing and contracting, and financial incentives (general).

Data Extraction

Data from each study were extracted on type of study, intervention, and clinical outcome being investigated; magnitude of the effect; the study’s importance for quality; and areas of knowledge still needed.

ARTICLES INCLUDED

The flow chart depicted in Figure B-1 illustrates the articles initially identified in the literature search and each step of the exclusion process.

Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×
Page297
Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×
Page298
Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×
Page299
Suggested Citation:"Appendix B: Methods for Rapid Review." National Academies of Sciences, Engineering, and Medicine. 2018. Crossing the Global Quality Chasm: Improving Health Care Worldwide. Washington, DC: The National Academies Press. doi: 10.17226/25152.
×
Page300
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In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally.

Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas.

Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.

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