Strategies for optimising health system managers' engagement in quality improvement projects: lessons learnt from the...

Area of Science:

• Healthcare Management
• Quality Improvement Science
• Organizational Behavior

Background:

• Quality improvement (QI) strategies are crucial for enhancing healthcare quality, safety, and efficiency.
• Managerial involvement is critical for QI initiatives but often underdocumented.
• This study investigates managerial roles within the COMPAS+ quality improvement collaborative for chronic disease care in Quebec.

Purpose of the Study:

• To examine the specific roles and contributions of managers in quality improvement projects.
• To deepen the understanding of effective managerial engagement in healthcare quality initiatives.
• To identify factors influencing the success of quality improvement projects in chronic disease management.

Main Methods:

• A qualitative case study design was employed, comparing four regional health networks participating in COMPAS+ (2016-2019).
• Data were collected through thematic analysis of workshop reports, action plans, and interviews with 24 key stakeholders.
• Methodology was informed by literature on decision-makers' roles in QI projects and project management.

Main Results:

• Variability in project management and role distribution across management levels (upper, middle, lower) was observed.
• Upper management provided strategic direction, middle management executed projects, and lower management coordinated local changes.
• Middle managers often lacked role clarity and training, and a gap in methodological guidance from facilitators impacted project adherence and potential.

Conclusions:

• Well-defined managerial roles, adequate training, and inter-level communication are essential for effective QI project management.
• Integrating a facilitator role is vital for providing methodological expertise and ensuring adherence to QI processes.
• External QI expertise can complement contextual knowledge and local leadership for improved outcomes.