Alagoz et al. (2018) - The use of external change agents to promote quality
improvement and organizational change in healthcare organizations: a systematic
review
Background
Change agents: introduce innovations into a client system that they expect will have
consequences that will be desirable, direct, and anticipated
Paper focuses on external change agents = individuals who are affiliated with an outside
entity who formally influence or facilitate intervention decisions in a desirable direction
→ usually have professional training
→ e.g. outside researchers
Synonyms change agents: facilitator, coach, perceptor, consultant, and mentor
Examples of implementation strategies where external change agents have essential role:
use an improvement/implementation advisor
conduct educational outreach visits
conduct ongoing training
external facilitation
External change agent usually responsive for delivering the implementation strategy →
related to intended strategy and its ultimate success in achieving desired organizational
changes
This systematic review: examine the role that external change agents have played in
promoting organizational change in HC
→ focus on primary care clinics → often lack the kind of internal quality improvement
resources that are relatively common in larger healthcare organizations
Methods
The protocol for this systematic review was designed in accordance with PRISMA
guidelines
Engaged a research librarian and field experts
included randomized controlled trials that investigate process improvement activities
in healthcare organizations (general practices, primary care practices, private
practices, and outpatient clinics) through external change agents
focus on organisational change instead of individual health behaviour change
selected articles in 2 phases: reviewing titles and abstracts + reviewing full text
articles
independently reviewed the final list of full-text articles based on
1. intervention type
2. setting
3. study design
4. intervention components
5. background of change agents
6. background of settings
7. intervention duration and frequency of contact
8. outcome measures
9. significance
also assessed the quality of clinical trials included in this study → i.e. rating risk of
bias
improvement and organizational change in healthcare organizations: a systematic
review
Background
Change agents: introduce innovations into a client system that they expect will have
consequences that will be desirable, direct, and anticipated
Paper focuses on external change agents = individuals who are affiliated with an outside
entity who formally influence or facilitate intervention decisions in a desirable direction
→ usually have professional training
→ e.g. outside researchers
Synonyms change agents: facilitator, coach, perceptor, consultant, and mentor
Examples of implementation strategies where external change agents have essential role:
use an improvement/implementation advisor
conduct educational outreach visits
conduct ongoing training
external facilitation
External change agent usually responsive for delivering the implementation strategy →
related to intended strategy and its ultimate success in achieving desired organizational
changes
This systematic review: examine the role that external change agents have played in
promoting organizational change in HC
→ focus on primary care clinics → often lack the kind of internal quality improvement
resources that are relatively common in larger healthcare organizations
Methods
The protocol for this systematic review was designed in accordance with PRISMA
guidelines
Engaged a research librarian and field experts
included randomized controlled trials that investigate process improvement activities
in healthcare organizations (general practices, primary care practices, private
practices, and outpatient clinics) through external change agents
focus on organisational change instead of individual health behaviour change
selected articles in 2 phases: reviewing titles and abstracts + reviewing full text
articles
independently reviewed the final list of full-text articles based on
1. intervention type
2. setting
3. study design
4. intervention components
5. background of change agents
6. background of settings
7. intervention duration and frequency of contact
8. outcome measures
9. significance
also assessed the quality of clinical trials included in this study → i.e. rating risk of
bias
