Table 1 Terminology and definitions for data extracted

Problem/

Solution

Problem

The gap in NH care and/or patient outcomes that authors targeted for improvement

Solution

The approach selected to address a problem, defined broadly to include both systems level changes to improve the quality of care delivery and clinical intervention programs, practice guidelines, policies and procedures [58].

Project name

The name authors provided for the study or project to address a problem

QI Strategies

Site champion

Designate an individual who will promote and support an initiative [31]

QI or implementation team

Teams that were establish and supported to plan and guide implementation [31]

Technical assistance

Interactive support that is individualized to the specific needs of individuals or teams [59]

Training: in-person or virtual

Educational and/or skill-building sessions [59]

Tools/Toolkits

Electronic or print resource used to plan, deliver, implement, or evaluate a solution [59]

Process mapping

Methods used to visually represent the way a care process works, referred to as a process map or flow chart [17, 60]

Root cause analysis

Methods used to gain diverse perspectives on factors contributing to a problem. Includes Ishikawa or fishbone diagram and the five why’s exercise, among others [17]

Audit and feedback

Methods used to collect and summarize performance data and report it those implementing a solution [31]

Plan-do-study-act cycles (PDSA)

A multistep, rapid, and cyclical process for assessing whether a change led to improvement [17]

Quality monitoring systems

Systems and procedures that are developed to monitor care delivery and/or outcomes for the purpose of quality improvement [31]

Health record modifications

Change the health record to support implementation of the solution [31]

Learning collaborative

Bringing together staff and providers from multiple organizations to foster a “collaborative learning environment” [31]

Implementation outcomes

Adoption

Proportion of NHs invited that agree to participate in a QI initiative” [33]

Reach to staff

Number and/or proportion of eligible staff who participate in a QI initiative [33]

Reach to residents

Number and/or proportion of eligible NH residents who received or were exposed to a solution [33]

Fidelity

The degree to which a clinical intervention or QI strategy was implemented as prescribed/intended [28]

Perceptions of the solution and/or QI strategies

Perceptions among stakeholders that solutions and/or QI strategies were acceptable, appropriate, and/or feasible [28]

Maintenance

Extent to which a newly implemented solution was sustained over time [33]

Effectiveness Outcomes

Service outcomes

Changes in the quality of services delivered, with quality encompassing efficiency, safety, effectiveness, equity, patient-centeredness, and timeliness [28]

Resident outcomes

Changes in the health and wellbeing of NH residents [28]