Expanding Our Methodological Toolbox to Improve Quality: The Role of Mixed-Methods Evaluations

The delivery of care for cardiovascular disease involves multiple clinical team members across various settings, but the majority of quality improvement interventions in cardiovascular care are based on quantitative evidence alone. This approach does not fully account for multilevel determinants or contextualization from key informants. A mixed-methods approach, combining qualitative and quantitative data and analyses, would enhance the rigor and effectiveness of these interventions. This article describes a complex mixed-methods study that aims to improve infection prevention for durable left ventricular assist device therapy by evaluating interhospital variability, understanding local practice patterns, and integrating both data sources to gain a comprehensive understanding of the findings.