Table 1.
Steps of a clinical audit cycle and a standards-based audit.
Table 2.
Status in each step of a complete factorial stepped wedge design for 2 interventions, with 4 steps, by sequence.
Table 3.
a Frequency distribution of pairs of standards selected by facilities.
b Cross-tabulation of an allocation of facilities to sequences of standards.
Fig 1.
Schematic representation for Design A of data collection and action for a single standard.
0 (in pale yellow cells) denotes assessment of compliance with the standard under the current standard of care. T (in pale grey cells) denotes a transition month in which action is taken after review of data collected previously. 1 (in orange cells) denotes assessment of compliance after taking action to improve the quality of care delivery for the standard. Within each sequence the audit cycle phases are indicated by boldly bordered sets of three-month periods.
Fig 2.
Schedule of assessments for a facility in sequence 1 in Design A.
X(a) indicates that data for Sa was to be collected in that month. T(a) indicates that data for Sa was to be reviewed and action taken. X(a,b) indicates that data for Sa and Sb was to be collected in that month. X(b) and T(b) are similarly defined. Pale yellow and orange cells respectively indicate measurements obtained under the current standard of care and after action. Pale grey cells indicate months in which action is taken.
Table 4.
Status in each Step of a four-dimensional incomplete stepped wedge design with 6 steps, by sequence for pairs of standards.
Fig 3.
Example set of three completely balanced Latin squares indicating the sequences in which standards are audited in Design B.
Fig 4.
Schematic representation for design B of data collection and action for standard Sa.
0 denotes assessment of compliance with the standard under the current standard of care. T denotes a transition month in which action is taken after review of data collected previously. 1 denotes assessment of compliance after taking action to improve the quality of care delivery for the standard. Within each sequence the audit cycle periods are indicated by boldly bordered sets of three-month periods.
Fig 5.
Schedule of assessments for the facility in row 1 of square I in design B.
X(a) indicates that data for Sa was to be collected in that month. T(a) indicates that data for Sa was to be reviewed and action taken. X(b), X(c), X(d), X(e), X(f) and T(b), T(c), T(d), T(e), T(f) are similarly defined. X(a,b,c,d,e,f) indicates that data for Sa, Sb, Sc, Sd, Se and Sf was to be collected in that month.