Quality improvement

Evidence searches for quality improvement.

The suggested time to allocate to this search is 3 to 6 hours.

Planning

If possible, arrange a meeting with the requester to understand the aims and background of the project. If there is a project group, join it, or at least attend a meeting to get full brief of project.

Execution

Search for existing quality improvement (QI) projects that are similar, as well as for regular (non-QI specific) evidence for the project.

If you have access to a network of QI projects, such as Life QI, check this to see if any similar QI projects are listed.

Search for relevant guidelines from international, national and local sources as appropriate. For example:

  • Trip Database
  • National Institute for Health and Care Excellence (NICE)
  • Clinical Decision Support tools (for example. DynaMed Plus contains links to various international guidelines)

Search bibliographic databases such as:

  • Association for Management Education and Development (AMED)
  • British Nursing Index (BNI)
  • Cumulative Index to Nursing & Allied Health Literature (CINAHL)
  • Embase
  • Emcare
  • Health Management Information Consortium (HMIC)
  • Medline
  • PsycINFO
  • PubMed

You can also search preprint servers (Europe PubMed Central) and Google Scholar for books or other published information.

If you need to use Google search for examples of what other NHS organisations have done

If you need to use Google search for examples of what other NHS organisation have done, you should try the below.

Include “NHS” in your terms, and/or specify your country as UK, and/or limit the search to sites ending with “…nhs.uk” URLs using the limits "site:nhs.uk" or "inurl:nhs".

Use the "doctype:doc" or "doctype:pdf" limits to pick up policy documents and guidelines from around the country.

A search using the Carrot2 search engine may also present you with new evidence.

Search grey literature sources and subject-specific sites such as :

  • independent charities
  • governmental and nongovernmental organisations
  • think tanks like The Health Foundation, The King's Fund, Nuffield Trust and Health Quality Improvement Partnership (HQIP)

Search British medical journal (BMJ) Open Quality and BMJ Quality and Safety via their websites, for articles and commentary.

Search locally within your book and ebook catalogue for anything additional that could be useful, including general texts on the area of interest, and guidance on conducting a QI project if needed.

If your service keeps a core list of QI resources that could be useful for the requester to read then search within this and/or direct the requesters to this.

Consider directing the requester towards the Centre for Sustainable Healthcare’s Sustainability in Quality Improvement (SusQI) framework.

Results

Categorise your dedup licated results, including links to the full text wherever possible, and highlight key ones to make your report user-friendly.

Examples

Example 1

Request received via email

“I’m a registrar in Emergency Medicine, working at … I am currently writing up a Quality Improvement Project (QIP) and would like some help with the Literature review. My QIP aims to improve the management of Children presenting [at] (… my previous employer, where I started this QIP) Children’s Emergency Department with wheeze:

To reduce the number of children with mild and moderate wheeze admitted to CAU by reducing the time taken to give the treatment and reducing the absolute time needed to ‘stretch’ from the burst, thus safely delivering the treatment and review period within the ED four hour window.

By changing the guidelines to make them easier to follow, we hoped to increase the adherence to them. We altered the tick box check list to ensure robust safe discharge and reduce the risk of re attendance. Would you be able to search to see what evidence there is regarding:

  1. The timings of giving inhalers there in acute asthma/wheeze presentation.
  2. Adding Ipratropium inhaler to the burst for moderate symptoms
  3. Reviewing at 3 hours after treatment as an appropriate length of time to safely review response to treatment and facilitate discharge
  4. Also Is there any research on QIP projects and how to successfully implement change.

Response from librarian

Dear …

Hope this email finds you well. Please find attached the results of your requested search on: “What is the accuracy of transcutaneous CO2 monitors compared to arterial blood gases" [results from 2010-, adult populations only]

The attached report contains the results of a systematic search of several healthcare databases and wider sources, arranged in reverse chronological order, with high tier evidence first of all.

I searched using a broad/sensitive strategy for any/all articles covering monitoring of both transcutaneous CO2 and arterial blood gases. If you are aware of any relevant research my search has not retrieved then do please let me know and I'll use that information to reiterate the search. If you would like me to search again with different criteria, if this report is not what you had in mind, or if you would like me to present the results in a different format then again please inform me and I'll be happy to oblige. We can also set up alerts so that you'll be notified whenever new research is published in this area, or we can set you up for regular bulletins outlining the latest news/research in this area.

From the attached report you can view the full text of the articles relevant to you by clicking on the blue links to download them using your OpenAthens login details. If you do not currently have an OpenAthens account you can register for one using your NHS email address. You will be sent an email to set your own password.

The articles we do not have direct access to will have to be ordered through our inter-library loans service which may take a few days to arrive. To make article requests you will need to fill out the journal requests form on the Knowledge library services web page at: [link to online form]

We aim to improve our services in line with your comments. If you could please take a moment to [complete our online feedback form here] we would be very grateful. Could we also contact you to hear how the search impacted your decision making, for a case study please?

Look forward to hearing from you…

Report compiled by librarian.

Page last reviewed: 7 August 2023
Next review due: 7 August 2024