Abstract

Background: Patient safety and quality is a priority for healthcare; however, the literature suggest worsening trends indicating greater risks of harm from medical care. One challenge is that healthcare is a complex system dependent on human interactions. Studies show that programs that improve communication decrease the risks of adverse events. A case study exploring a formative program evaluation shows an approach for understanding how a formal application of communications theory might improve patient safety and quality within a Medical Center.

Methods: A project team conducted operationalizing formative program evaluations using program logic modeling. The team conducted a formative program evaluation of an exemplar human communications improvement curriculum titled The VitalSmarts® Crucial Conversations™ program. Then the team conducted a formative program evaluation of a pilot program implementing Crucial Conversations™ theory. The two logic models were compared to assess overall program fidelity.

Result: This case study demonstrated where there was not fidelity between a major medical center’s program and an archetypical patient safety and quality program focused on improving human communications.

Conclusion: The formative program evaluation is a rigorous methodology for assessing program performance and specifying improvement. The program logic model is a valuable tool for effectively transitioning from a conceptual program to a formal program that complements multiple methodologies for comprehensively evaluating patient safety and quality improvement programs.

Keywords: Patient safety; Quality improvement; Process theory; Program evaluation; Program logic model; Change theory