Towards comprehensive fidelity evaluations: consideration of enactment measures in quality improvement interventions

Within healthcare services worldwide, there is a continual emphasis on innovation, including the development, evaluation and improvement of new and existing healthcare interventions and services to improve patient outcomes. In addition to evaluating efficacy, it is also important to evaluate how innovations are used in ‘real-world’ settings. A key part of this is process evaluation: understanding how interventions and services are implemented and engaged with. For example, recent Medical Research Council guidance on researching the effectiveness of complex interventions highlights the importance of measuring implementation and context, including the measurement of ‘fidelity’.1 ‘Fidelity’ has been proposed to have five related domains, including fidelity of design, training, delivery (whether intervention components, as outlined in the intervention protocol, are delivered as planned), receipt (whether participants understand and are able to perform required skills) and enactment (whether participants use skills in daily life).2 Both receipt and enactment have...
Source: Quality and Safety in Health Care - Category: Health Management Authors: Tags: Editorials Source Type: research