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Leading healthcare improvement: an implementation strategy
Kelley Arredondo1,2,3,4, Anthony Ecker5,6,7, Lindsay Vaclavik5,8
1Houston VA HSR&D Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, MEDVAMC 156, 2002 Holcombe Blvd., Houston, TX, USA. Kelley.Arredondo@bcm.edu.
Introduction:
Healthcare professionals often implement quality improvement (QI) initiatives but lack training to implement and sustain QI initiatives. Leading Healthcare Improvement (LHI) is a course that combines principles from change management, team science, and leadership effectiveness into an implementation strategy to enable clinicians to lead sustainable change.
Methods:
LHI is a 6-session, 4-month interactive training. Learners work on an active QI project throughout the course. A Wilcoxon signed-rank test was conducted to evaluate pre- and post-course changes in learners' self-reported confidence across five QI competencies.
Results:
Veterans Healthcare Administration clinicians and fellows completed the LHI pre- (n = 111) and post-course (n = 74) evaluations with 70 responding to both evaluations. The 70 learners self-reported significantly increased confidence after the training in each of the QI competencies: communicating urgency (W = 56, p < 0.001), developing and leading interprofessional teams (W = 48, p < 0.001), creating and communicating project vision (W = 54, p < 0.001), developing strategies to remove barriers (W = 60, p < 0.001), and communicating project impacts to leadership (W = 62, p < 0.001).
Discussion:
LHI is an implementation strategy curriculum intended to support healthcare professionals in leading system-level changes. Its emphasis on key partner influence, interprofessional teamwork, and real-time project application may help address gaps in existing training and has the potential to strengthen capacity for sustained healthcare improvement.
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