Characteristics of quality improvement interventions to improve physical healthcare in mental health settings: a scoping review protocol

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Abstract

Introduction

Mental health concerns globally impact millions of people, resulting in significant financial impact and adverse health outcomes. People living with mental health concerns are at higher risk of developing physical health issues, which can lead to a shortened life expectancy. Barriers to physical healthcare, such as limited service capacity, low help seeking and stigma, contribute to health disadvantage. Quality improvement (QI) interventions can address these challenges by addressing staff-level and service-level factors to improve the focus on physical healthcare in mental health settings. The aim of this scoping review is to describe studies of QI interventions to improve physical healthcare in mental health settings.

Methods and analysis

The proposed scoping review will be conducted in accordance with guidance for scoping reviews from the Joanna Briggs Institute Manual and in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A systematic review search for peer-reviewed and published articles will be conducted across eight databases: PubMed, MEDLINE (Ovid), Web of Science, CINAHL (EBSCOhost), ProQuest Central, PsycINFO (Ovid), Scopus and Embase (Elsevier). Two independent reviewers will screen the titles, abstracts and full text using Covidence. Any disagreement will be resolved through discussion or with a third reviewer. Data collection will be facilitated using Microsoft Excel. The details of included studies will be extracted by two authors independently.

Ethics and dissemination

No ethical approval is required for the scoping review. The results of this review will be presented at conferences and published in a peer-reviewed scientific journal. This review will also inform the development of a QI strategy to influence mental health staff practices in the provision of physical healthcare in Australian mental health settings.

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PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Adrian Aldcroft, Chantelle Garritty, Simon Lewin … (2018)

Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.

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Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Laura Damschroder, David Aron, Rosalind E Keith … (2009)

Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.

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Developing and evaluating complex interventions: the new Medical Research Council guidance

Peter Craig, Paul Dieppe, Sally Macintyre … (2008)

Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance

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Author and article information

Contributors

Di Hu:

twitter: @Annahudidi

ORCID: http://orcid.org/0009-0008-3369-1545

Victoria Stewart:

twitter: https://twitter.com/v_stewart001

ORCID: http://orcid.org/0000-0003-2892-2288

Amanda J Wheeler:

twitter: @AmandaJWheeler1

ORCID: http://orcid.org/0000-0001-9755-674X

Geoffrey Lau:

ORCID: http://orcid.org/0000-0003-2333-8461

Justin Chapman:

ORCID: http://orcid.org/0000-0002-2958-2783

twitter: @justinjchapman

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2024

Publication date (Electronic): 22 July 2024

Volume: 14

Issue: 7

Electronic Location Identifier: e083753

Affiliations

[1 ]departmentCentre for Mental Health , Griffith University , Brisbane, Queensland, Australia

[2 ]departmentSchool of Pharmacy and Medical Sciences , Griffith University , Brisbane, Queensland, Australia

[3 ]departmentMenzies Health Institute Queensland , Griffith University , Brisbane, Queensland, Australia

[4 ]departmentSchool of Pharmacy, Faculty of Health and Medical Sciences , University of Auckland , Auckland, New Zealand

[5 ]departmentThe ALIVE National Centre for Mental Health Research Translation , The University of Melbourne , Melbourne, Victoria, Australia

[6 ]Metro South Health , Brisbane, Queensland, Australia

Author notes

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

None declared.

DiHu; di.hu@ 123456griffith.edu.au

Author information

Di Hu http://orcid.org/0009-0008-3369-1545

Victoria Stewart http://orcid.org/0000-0003-2892-2288

Amanda J Wheeler http://orcid.org/0000-0001-9755-674X

Geoffrey Lau http://orcid.org/0000-0003-2333-8461

Justin Chapman http://orcid.org/0000-0002-2958-2783

Article

Publisher ID: bmjopen-2023-083753

DOI: 10.1136/bmjopen-2023-083753

PMC ID: 11268065

PubMed ID: 39038868

SO-VID: f73476bc-f7af-428e-a088-ed6d783632b5

License:

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Characteristics of quality improvement interventions to improve physical healthcare in mental health settings: a scoping review protocol

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Abstract

Abstract

Introduction

Methods and analysis

Ethics and dissemination

Related collections

Emerald: Healthier Lives

Most cited references 29

PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Developing and evaluating complex interventions: the new Medical Research Council guidance

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Contributors

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Author notes

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