![]() The guidance aims to advance the value of toolkits as an emerging method to effectively disseminate interventions to improve the quality of care. The authors established a set of key recommendations and suggestions addressing the content, development, and evaluation methods of quality improvement toolkits, together with a ready-to use checklist. The recommendations are accompanied by 11 suggestions for toolkit content, 9 suggestions for development methods, and 6 suggestions for toolkit evaluation methods. The panel established 12 recommendations for content and 1 recommendation for toolkit development methods. A modified Delphi process established recommendations and suggestions to guide toolkit development. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. Ī burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. PROSPERO registration number: PROSPERO 2014: CRD42014013930. ![]() While emerging evidence indicates positive effects on clinical processes, more research on toolkit value and what affects it is needed, including linking toolkits to objective provider behavior measures and patient outcomes. The existing evidence base on the effectiveness of toolkits remains limited. High satisfaction with toolkits can be achieved but the usefulness of individual tools may vary. Available uptake data are limited but indicate variability. CONCLUSIONS: The review documents publicly available toolkits and their components. Only 29% reported patient data and, overall, results from robust study designs are missing from the evidence base. Provider data were reported in 40% of studies but were primarily self-reported changes. Across studies, 57% reported on adherence to clinical procedures and toolkit effects were positive. Studies generally indicated high satisfaction with toolkits, but the perceived usefulness of individual tools varied. Uptake data were limited and toolkit uptake was highly variable. Pre-post studies were most common (55%) 10% were single hospital evaluations and the number of participating staff ranged from 17 to 704. Most toolkits included introductory and implementation material (e.g., research summaries) and healthcare provider tools (e.g., care plans), and two-thirds included material for patients (e.g., information leaflets). Toolkits addressed a variety of quality improvement approaches and focused on clinical topics such as weight management, fall prevention, vaccination, hospital-acquired infections, pain management, and patient safety. RESULTS: In total, 77 studies evaluating 72 toolkits met inclusion criteria. Findings, summarized in comprehensive evidence tables and narrative synthesis addressed the uptake and utility, procedural and organizational outcomes, provider outcomes, and patient outcomes. One reviewer abstracted data and appraised the studies, checked by a second reviewer reviewers resolved disagreements through discussion. ![]() Two independent reviewers screened publications for inclusion. METHODS: We searched PubMed, CINAHL, and the Web of Science from 2005 to May 2018 for evaluations of publicly available toolkits, used a forward search of known toolkits, screened references, and contacted topic experts. We aimed to determine the components, uptake, and effectiveness of publicly available toolkits. BACKGROUND: The objective was to conduct a systematic review of toolkit evaluations intended to spread interventions to improve healthcare quality.
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