"Learn from each other": A qualitative exploration of collaborative quality improvement

Area of Science:

• Surgical Quality Improvement
• Healthcare Management
• Medical Education

Background:

• Collaborative quality improvement is a proven method for enhancing surgical care.
• Surgeon experiences and perceptions within these collaboratives are not well understood.
• This study explores themes of surgeon participation in collaborative quality improvement.

Purpose of the Study:

• To elicit common themes regarding surgeons' experiences and perceptions in collaborative quality improvement.
• To understand the motivational factors and learning mechanisms within surgical quality improvement collaboratives.

Main Methods:

• An interpretive description qualitative study was conducted.
• Semi-structured interviews were performed with surgeons in the Michigan Surgical Quality Collaborative.
• A sample of 24 surgeons participated in the interviews.

Main Results:

• Two major themes emerged: contextualization of individual performance and peer learning.
• Comparing individual performance to peers motivated improvement and was perceived as collaborative, not punitive.
• Peer learning, drawing from institutional practices, was the primary driver for practice change and overcoming hesitancy.

Conclusions:

• Contextualization of outcomes and peer learning are key themes in surgeons' experiences with collaborative quality improvement.
• Collaborative quality improvement leverages peer comparison for motivation and peer-derived evidence for practice change.
• Highlighting peer success helps surgeons overcome hesitancy to change, as seen in initiatives like reducing opioid prescribing.