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Contextual Factors Affecting Implementation of Pediatric Quality Improvement Programs.

Elizabeth L Cope1, Margaret Johnson2, Marya Khan1

  • 1AcademyHealth (EL Cope and M Khan), Washington, DC.

Academic Pediatrics
|March 27, 2022
PubMed
Summary
This summary is machine-generated.

Quality improvement programs are most effective when considering context. Incentives, resources, and organizational capacity were key factors influencing pediatric quality measure implementation across diverse projects.

Keywords:
contextual factorsimplementation sciencepediatric quality measures

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Area of Science:

  • Healthcare Quality Improvement
  • Health Services Research
  • Pediatric Health

Background:

  • Contextual factors significantly influence the success of healthcare quality improvement initiatives.
  • The Agency for Health Care Research and Quality's Pediatric Quality Measure Program (PQMP) involved diverse projects.

Purpose of the Study:

  • To assess the role of contextual factors in the effectiveness of five distinct quality improvement projects within the PQMP.
  • To identify key determinants influencing the implementation of pediatric quality measures.

Main Methods:

  • A mixed-methods approach was employed, combining semistructured interviews and structured worksheets.
  • Data were collected from 15 participants across five PQMP grantee teams between August and October 2020.
  • Analysis utilized the Tailored Implementation for Chronic Diseases (TICD) framework for coding and interpretation.

Main Results:

  • Professional interactions, incentives and resources, and organizational change capacity were commonly identified influential domains across projects.
  • Payer or funder policies emerged as a highly influential factor, despite social, political, and legal factors being less frequently cited.
  • The incentives and resources domain was identified as the most impactful across the diverse quality improvement initiatives.

Conclusions:

  • A determinant framework like TICD aids in comparing heterogeneous quality improvement projects and identifying critical contextual factors.
  • Future quality improvement efforts should integrate support for infrastructure development alongside program implementation.
  • Understanding and addressing contextual factors is crucial for successful pediatric quality measure implementation in various settings.