Concurrent implementation of quality improvement programs.

Area of Science:

• Healthcare Management
• Organizational Learning
• Quality Improvement

Background:

• Competing projects can hinder the adoption of new knowledge and practices.
• Healthcare organizations often face challenges in coordinating multiple quality initiatives simultaneously.

Purpose of the Study:

• To investigate the processes and impact of implementing two concurrent quality initiatives in a Swedish hospital.
• To understand the interplay between a regional organizational learning program (Dynamic and Viable Organization - DVO) and a national infection control initiative (Stopping Healthcare-Associated and Hospital-Acquired Infections - SHAI).

Main Methods:

• A multi-method approach was employed, including surveys, observations, interviews, process diaries, document analysis, and organizational measurements.
• Data were collected from unit managers, change facilitators, and improvement team members.

Main Results:

• Despite sharing a common improvement approach, the DVO and SHAI initiatives were not strongly integrated.
• The initiatives operated with a degree of coordination and conflict, lacking explicit management strategies for synergy.
• Positive developments in quality improvement culture and communication were reported, even without dedicated management for the SHAI initiative.

Conclusions:

• Coordinating concurrent change initiatives, even under favorable conditions, presents inherent difficulties.
• This study addresses the under-researched but common issue of competing projects within organizations.