Development and Testing of an Interactive Evaluation Tool: The Evaluating QUality and ImPlementation (EQUIP) Tool

Abstract

Background: This article describes the development of an interactive online tool that helps people build robust evaluations. Evaluating implementation outcomes is gaining momentum in health service delivery organizations. Teams are recognizing the importance of capturing and learning from their implementation efforts, and implementation scientists have published extensively on implementation outcomes. However, quality improvement approaches and tools are better known and routinely used in healthcare to improve processes and outcomes. An example of a widespread quality improvement tool is the Alberta Quality Matrix for Health, a planning and evaluation framework that guides most healthcare-related evaluations in Alberta, Canada. This matrix is missing measures of implementation, which are essential to produce robust evaluations of change initiatives. Despite requests to integrate implementation science and quality improvement concepts, there is a dearth of tools and training opportunities. This lack of integration limits improvement and implementation in the health system. Methods: This work aimed to co-design a product that helps users integrate quality and implementation outcomes and strengthen existing evaluation processes. Rapid, iterative co-design sessions and usability testing were used to develop an interactive evaluation tool. Feedback collected and analyzed from usability testing in the seven-month testing period refined the digital prototype into a comprehensive online product. Results: The result is the EQUIP (Evaluating QUality and ImPlementation) Tool. This online, interactive tool integrates quality measures from the Alberta Quality Matrix for Health and implementation measures from a commonly used outcomes framework developed by Proctor and colleagues. It allows users to explore implementation outcomes and quality dimensions from different perspectives and select questions and indicators relevant to their project. Conclusion: The EQUIP tool was co-designed and refined with end users to create an accessible and useful online tool. This work is an example of integrating quality and implementation science in ways that strengthen overall healthcare quality improvements.