Improving the Context Supporting Quality Improvement in a Neonatal Intensive Care Unit Quality Collaborative: An...

Area of Science:

• Healthcare Quality Improvement
• Organizational Psychology
• Medical Education

Background:

• Successful quality improvement (QI) initiatives depend on a supportive organizational context.
• Existing QI efforts may be hindered by suboptimal contextual factors.
• A structured approach to address context is needed for sustained QI success.

Purpose of the Study:

• To evaluate if a structured curriculum can empower QI teams to improve their supporting context.
• To explore how QI teams identify and intervene on contextual barriers.
• To understand the impact of curriculum-guided contextual modifications on QI work.

Main Methods:

• An exploratory field study involving 43 QI teams in a neonatal intensive care unit (NICU) collaborative.
• Utilized a curriculum based on the Model for Understanding Success in Quality.
• Analyzed survey data and self-reflective journals to assess contextual changes.

Main Results:

• Over half of the teams (55%) targeted contextual improvements within their microsystem.
• Key focus areas for improvement included team motivation and organizational culture.
• "Information sharing" was the most frequently tested intervention to engage staff.

Conclusions:

• A structured curriculum can guide QI teams in identifying and addressing contextual factors.
• Modifying the microsystem's context, particularly motivation and culture, is a feasible strategy for QI teams.
• Further research is required to confirm if contextual improvements translate to enhanced QI outcomes.