Table 1 Components of the SIMS intervention, specified according to the Template for Intervention Description and Replication (TIDieR) Checklist
SIMS components | Collaborative improvement meetings | Clinical performance audits and feedback | Clinical mentoring |
|---|---|---|---|
Why | To guide facility staff on implementing collaborative improvement plans | To assess how the Quick Check is applied in local practice settings and reinforce the need for high performance on specific quality indicators derived from the Quick Check | To guide clinicians on application of Quick Check in local practice settings |
What | Systematic assessment of local resources for severe illness management, goal setting by facility stakeholders with external supervision, and group problem-solving | Comprehensive monitoring of clinical performance through daily medical record extraction, with mentored review of regular performance indicator reports | Bedside teaching rounds and mentored reviews of clinical cases; simulation sessions for medical ward teams |
Who provides | Local champion | On-site data collectors and project manager | Visiting expert clinician |
How | In person with all clinical, administrative, and support staff | Data collection using CommCare, an open-source data collection platform; comprehensive performance reports delivered to clinical leaders at each site via email; focused messages about specific performance indicators delivered to individual clinical staff via SMS | Shadowing at the bedside |
Where | At the hospital | At the hospital | At the hospital |
When and how much | One hour twice a month | Email reports weekly SMS weekly | One full day each month |
Tailoring | We added a USD 1500 process improvement fund to enable facilities to act on improvement priorities. | The program manager developed reports and sent SMS using DHIS2, an open-source electronic health record platform approved by the Ministry of Health. | None |
Modifications | The clinical team used the pre-training facility assessment report to develop a work plan for quality improvement. | The clinical leader discussed the reports with staff during collaborative improvement meetings. | None |
How well | At least monthly at all 4 sites, bi-monthly at 2 sites | As designed | Every 4–6 months |