USE OF EXPERIMENTAL AND QUASI-EXPERIMENTAL METHODS FOR DATA-BASED DECISIONS IN QI

Background: Decisions made by quality improvement (QI) teams, as repor ted in the literature, are usually based on nonexperimental methods fo r data collection. Pretest-posttest designs, in particular, are common in reports of QI teams' evaluations of changes or interventions. Yet in such designs the results are inherently confounded; it is impossibl e to rule out alternative explanations for any differences found. Usin g experimental methods to make QI decisions: As suggested by one study , QI teams can design and implement experimental interventions in rele vant organizational processes. In an attempt to reduce the no-show rat e for first appointments at a Residents Clinic at the Medical Universi ty of South Carolina (Charleston), the Youth Outpatient improvement Te am designed an experiment to test two possible modifications to the ad mission process. Those seeking services were randomly assigned to one of three groups (the control group or one of the experimental groups). Not only did results not support the team's hypothesis that one of th e experimental procedures would produce a lower no-show rate, subjects in the experimental groups were less likely to enter treatment. Given these data, the decision was made to maintain current admission proce dures. Conclusions: Since the quality of a decision is dependent on th e quality of the data on which it is based, Qi teams should consider e xperimental methods when planning data collection to evaluate their re commended interventions. When such methods are not feasible, quasi-exp erimental strategies can be used to strengthen the quality of nonexper imental data.