Building Systemwide Improvement Capability: Does an Organization's Strategy for Quality Improvement Matter?

Area of Science:

• Healthcare Management
• Organizational Behavior
• Quality Improvement Science

Background:

• Health care organizations struggle to implement and spread quality improvement (QI) programs effectively.
• Varying success suggests organizational strategies impact QI capability development.
• Investigating the link between QI effort focus and organizational success is crucial.

Purpose of the Study:

• To examine how the primary focus of grant-funded QI efforts relates to grant success measures.
• To assess the relationship between QI effort focus and organization-level success in QI and organizational learning.

Main Methods:

• A mixed-methods design was employed.
• One-way analyses of variance related Veterans Affairs administrative survey data to evaluation data from 29 health care organizations.
• Qualitative data from the evaluation explained quantitative findings.

Main Results:

• Hospitals focusing on developing QI organizational infrastructure outperformed those focusing on training or projects.
• The infrastructure-focused group rated highest on all 4 grant success measures.
• The infrastructure-focused group also rated highest on all 3 systemwide QI and organizational learning measures.

Conclusions:

• Focusing solely on QI projects or staff training has limited impact.
• Developing organizational systems, structures, or processes is key for systemwide QI transformation.
• This research offers practical insights for health care leaders aiming to enhance organizational improvement capability.