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Updated: Jun 8, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

The science of quality improvement implementation: developing capacity to make a difference.

Jeffrey A Alexander¹, Larry R Hearld

¹Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA. jalexand@sph.umich.edu

|September 11, 2010

Summary

Implementing quality improvement (QI) in healthcare is challenging. Organizational processes and internal context significantly impact QI success, yet research often overlooks holistic frameworks and interactions between factors.

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

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Published on: February 16, 2011

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Last Updated: Jun 8, 2026

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time

Published on: February 19, 2021

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care

Published on: February 16, 2011

Area of Science:

Health Services Research
Organizational Behavior
Healthcare Management

Background:

Quality improvement (QI) initiatives aim to enhance healthcare delivery but face significant implementation hurdles within organizations.
A deeper understanding of organizational factors facilitating or hindering QI innovation is crucial for practitioners, managers, and researchers.

Purpose of the Study:

To conduct a critical review of existing empirical research on the implementation of quality improvement innovations in healthcare settings.

Main Methods:

A comprehensive literature review was performed, analyzing 107 studies focused on QI implementation in healthcare organizations.
Studies were systematically categorized based on predictor types: QI innovation content, organizational processes, internal organizational context, and external organizational context.

Main Results:

Internal context and organizational processes emerged as the most frequently investigated factors influencing QI implementation.
The external context and organizational processes demonstrated the highest frequency of positive associations with successful QI implementation.

Conclusions:

Significant gaps exist in the current quality improvement implementation literature, particularly concerning clear conceptual frameworks for research.
Many studies employ designs that isolate predictor effects, neglecting holistic approaches to capture complex interactions among implementation factors.
Limitations include reliance on cross-sectional designs, single-source data, and potential selection bias, hindering robust conclusions on QI implementation.