Rising through the pandemic: a scoping review of quality improvement in public health during the COVID-19 pandemic

  1. X. Cindy Yin
  2. Michelle Pang
  3. Madelyn P. Law
  4. Fiona Guerra
  5. Tracey O’Sullivan
  6. Rachel E. Laxer
  7. Brian Schwartz
  8. Yasmin Khan

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Abstract

Background

The COVID-19 pandemic generated a growing interest in and need for evidence-based tools to facilitate the implementation of emergency management strategies within public health practice. Quality improvement (QI) is a key framework and philosophy to guide organizational emergency response efforts; however, the nature and extent to which it has been used in public health settings during the COVID-19 pandemic remains unclear.

Methods

We conducted a scoping review of literature published January 2020 – February 2021 and focused on the topic of QI at public health agencies during the COVID-19 pandemic. The search was conducted using four bibliographic databases, in addition to a supplementary grey literature search through custom Google search engines and targeted website search methods. Of the 1,878 peer-reviewed articles assessed, 15 records met the inclusion criteria. An additional 11 relevant records were identified during the grey literature search, for a total of 26 records included in the scoping review.

Results

Records were organized into five topics: 1) collaborative problem solving and analysis with stakeholders; 2) supporting learning and capacity building in QI; 3) learning from past emergencies; 4) implementing QI methods during COVID-19; and 5) evaluating performance using frameworks/indicators.

Conclusions

The literature indicates that QI-oriented activities are occurring at the organizational and program levels to enhance COVID-19 response. To optimize the benefits that QI approaches and methodologies may offer, it is important for public health agencies to focus on both widespread integration of QI as part of an organization’s management philosophy and culture, as well as project level activities at all stages of the emergency management cycle.

Article activity feed

  1. Version published to 10.1186/s12889-022-12631-0
  2. ScreenIT

    SciScore for 10.1101/2021.06.08.21258002: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Four databases were selected to be comprehensive and inclusive of literature in the biomedical, public health, health science, and global health disciplines: MEDLINE,
    MEDLINE
    suggested: (MEDLINE, RRID:SCR_002185)
    The supplementary grey literature search was conducted by applying search strings to custom Google search engines tailored to generate results from relevant public health agency websites in Ontario, other provinces in Canada, the United States (US), and other international countries.
    Google
    suggested: (Google, RRID:SCR_017097)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations: This scoping review had a number of limitations. First, due to the rapid nature of the review, additional search methods (e.g., review of reference lists) were not undertaken; therefore, some relevant records may not have been not included. Second, any internal QI initiatives that were not posted publicly (e.g., access to restricted to organizational employees), or available in English language, were not included in the review; thus limiting the findings. Third, there is wide variation in the terminology used to refer to QI and improvement. Although our detailed search strategy sought to include the most commonly used terms, any terminology that does not appear in our search strings was excluded from the findings. Finally, the information summarized in this review includes records from a limited timeframe of the COVID-19 pandemic. The findings discussed are subject to change as the COVID-19 pandemic progresses, and the corresponding literature evolves and expands.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.06.08.21258002v1 on medRxiv