Comprehensive and Detailed Explanation:
High implementation compliance demonstrates that staff are performing the new process, but it does not prove that the process affects the desired clinical outcome. If readmission reduction was the intended goal and rates remain unchanged, the team should examine whether the checklist addresses the actual causes of readmission.
Possible contributors may include disease complexity, medication access, follow-up care, social determinants, patient understanding, transportation, discharge timing, or other factors outside the checklist's scope. The team should also evaluate whether the checklist's individual elements are evidence based and whether they are performed meaningfully rather than simply documented.
High compliance remains valuable information because it suggests lack of implementation is probably not the primary explanation for unchanged outcomes. However, the project's theory of change may need revision.
Stopping measurement because findings are unfavorable would prevent learning and potentially allow an ineffective intervention to continue indefinitely.
The current NPD-BC Program/Project Management and Process Improvement domain includes organizational performance indicators, quality/performance improvement methodologies, project management, and strategies for maximizing outcomes. NPD practitioners should distinguish successful implementation of a process from achievement of the broader outcome the process was intended to influence.