Torrence, Natasha Sydney
(2024)
Contextualizing Fidelity: Assessing Adherence to Evidence-Based Core Components and Associated Factors in a VA National Quality Improvement Program.
Master Essay, University of Pittsburgh.
Abstract
Background: High-risk patients, or complex care patients with high multimorbidity, contribute to the majority share of healthcare cost at Veterans Affairs (VA) Hospitals and are at an increased risk for poor health outcomes. At the VA, primary care teams are best geared to treat high-risk patients and prevent high hospital utilization and poor outcomes, but currently do not use practices that target this population. The RIVET QUERI program is a national quality improvement program aimed at increasing uptake of evidence-based practices designed for high-risk patients.
Aims: This study evaluates fidelity to a RIVET evidenced-based practice (EBP), the care assessment and care plan tool, as well as the number of unmet needs discovered through use of the tool. This study contextualized fidelity by describing the patterns of use of the tool amongst implementing sites, and the context in which these patterns take place.
Public Health Significance: EBP fidelity is a vital component of evaluating intervention and implementation studies and can also be used as an early process outcome. The data from this study provides study leaders with information about the setting in which high fidelity occurs. This information will be used to guide future implementation efforts of this tool.
Methods and Results: RIVET EBP data was collected through VA electronic health data and analyzed through descriptive statistics. Contextual factors were collected through a clinician survey administered at the start of implementation and analyzed through descriptive statistics.
Conclusion: Sites in the RIVET QUERI program demonstrated high EBP fidelity (80-90%), indicating some early success of implementation. Sites were organized into two different patterns of use- ‘complete use’ and ‘variable use’ sites. ‘Complete use’ sites, which were characterized by more comprehensive use of the tool, found more unmet needs in the patients that were assessed.
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Details
| Item Type: |
Other Thesis, Dissertation, or Long Paper
(Master Essay)
|
| Status: |
Unpublished |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Torrence, Natasha Sydney | nst21@pitt.edu | nst21 | |
|
| Contributors: |
| Contribution | Contributors Name | Email | Pitt Username | ORCID |
|---|
| Thesis advisor | Coulter, Robert WS | robert.ws.coulter@pitt.edu | robert.ws.coulter | UNSPECIFIED | | Committee Member | Rosland, Ann-Marie | roslandam@pitt.edu | roslandam | UNSPECIFIED |
|
| Date: |
26 June 2024 |
| Date Type: |
Completion |
| Submission Date: |
21 June 2024 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
56 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master Essay |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
fidelity, Veterans, VA, evidence-based practice, EBP, evaluation, QUERI, quality improvement |
| Date Deposited: |
27 Jun 2024 02:56 |
| Last Modified: |
27 Jun 2024 02:56 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46618 |
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