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Interactional Resources for Quality Improvement: Learning From Participants Through a Qualitative Study
Joanna Veazey Brooks1, Ksenia Gorbenko, Charles Bosk
1Department of Health Policy and Management, University of Kansas School of Medicine, Kansas City (Dr Brooks); Department of Population Health Science and Policy, Institute of Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York (Dr Gorbenko); and Department of Sociology, Department of Anesthesia and Critical Care, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Dr Bosk).
Hospital teams implementing quality improvement projects need external perspectives, peer learning, and validation. These interactional resources are crucial for project success and sustainability.
Area of Science:
- Healthcare Management
- Quality Improvement Science
- Organizational Behavior
Background:
- Hospital quality improvement (QI) initiatives require significant leadership commitment, including resources.
- The specific interactional support needed for QI project implementation remains underexplored.
Purpose of the Study:
- To identify the types of interactional support sought by hospital teams during surgical quality improvement projects.
Main Methods:
- Conducted 26 site visits across 16 hospitals between 2012 and 2014.
- Utilized observations, interviews (n=321), and focus groups (n=28) for data collection.
- Employed inductive thematic analysis of recorded and transcribed interviews.
Main Results:
- Teams sought critical external perspectives on implementation progress.
- Opportunities for peer learning, particularly regarding clinical innovations, were highly valued.
- External validation was needed to enhance project visibility and commitment.
Conclusions:
- Quality improvement in hospitals is both a clinical and social process.
- Interactional resources are essential for successful QI implementation.
- In-person site visits can provide vital support, fostering momentum and sustainability.