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Factors that influence the implementation of quality improvement programmes.

Joseph Adrien Emmanuel Demes1,2, Lambert Farand2, Marie-Pascale Pomey2

  • 1School of Medicine and Pharmacy, UEH, 89, Rue Oswald Durand, Port-Au-Prince, Haiti.

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|July 11, 2025
PubMed
Summary
This summary is machine-generated.

Implementing quality improvement programs like HEALTHQUAL in Haiti requires understanding key facilitators and barriers. Collaboration, leadership, and team ownership are crucial, while sociopolitical context and resource limitations pose significant challenges.

Keywords:
determinants of implementationexternal evaluationhealth information technologyimplementation sciencepatient safetyquality improvementsystems science

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Area of Science:

  • Healthcare Management
  • Public Health Policy
  • Health Systems Strengthening

Background:

  • Poor-quality healthcare negatively impacts morbidity and mortality.
  • Strategies to improve healthcare processes, patient satisfaction, and access to quality care are essential.
  • Haiti's Ministry of Public Health and Population, donors, and partners promote quality improvement programs, including the HEALTHQUAL program.

Purpose of the Study:

  • To identify factors facilitating and hindering the implementation of quality improvement programs in Haiti.
  • To provide insights for optimizing the rollout of the HEALTHQUAL program within the Haitian health system.

Main Methods:

  • Qualitative evaluative research using a multiple case study design.
  • Conducted 38 semistructured interviews, observations, and document analysis.
  • Utilized constant comparative method and synthetic analysis framework with Atlas.ti software for data analysis.

Main Results:

  • Facilitating factors include inter-level collaboration, leadership, multidisciplinary teamwork, external pressures, network characteristics, team ownership, and quality infrastructure.
  • Inhibiting factors include sociopolitical context, organizational culture, policy legacy, provider perceptions, lack of accountability, inadequate health information systems, and resource scarcity.

Conclusions:

  • Leaders and decision-makers should consider identified contextual factors for successful HEALTHQUAL program planning and implementation in Haiti.
  • A comprehensive understanding of contextual variables is vital for effective implementation at any point in time.