title: Associations between organizational characteristics and quality improvement activities of clinics participating in a quality improvement collaborative.
abstract: BACKGROUND
  Few studies have rigorously evaluated the associations between organizational characteristics and intervention activities of health care organizations participating in quality improvement collaboratives (QICs).
  
  
  OBJECTIVE
  To examine the relationship between clinic characteristics and intervention activities by primary care clinics that provide HIV care and that participated in a QIC.
  
  
  METHODS
  Cross-sectional study of Ryan White CARE Act (now called Ryan White HIV/AIDS Treatment Modernization Act) funded clinics that participated in a QIC over 16 months in 2000 and 2001. The QIC was originally planned to be a more typical 12 months long, but was extended to increase the likelihood of success. Data were collected using surveys of clinicians and administrators in participating clinics and monthly reports of clinic improvement activities.
  
  
  METHODS
  Number of interventions attempted, percent of interventions repeated, percent of interventions evaluated, and organizational characteristics.
  
  
  RESULTS
  Clinics varied significantly in their intervention choices. Organizations with a more open culture and a greater emphasis on quality improvement attempted more interventions (P < 0.01, P < 0.05) and interventions that were more comprehensive (P < 0.01, P < 0.10). Presence of multidisciplinary teams and measurement of progress toward quantifiable goals also were associated with comprehensiveness of interventions (P < 0.01, P < 0.05).
  
  
  CONCLUSIONS
  Clinic characteristics predicted intervention activities during a QIC. Further research is needed on how these organizational characteristics affect quality of care through their influence on intervention activities.
authors.affiliation: Kellogg School of Management, Northwestern University, Evanston, Illinois 60208, USA. s-deo@kellogg.northwestern.edu
authors.forename: Sarang
authors.initials: S
authors.lastname: Deo
authors.forename: Keith
authors.initials: K
authors.lastname: McInnes
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Corbett
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
authors.forename: Martin F
authors.initials: MF
authors.lastname: Shapiro
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wilson
authors.forename: Paul D
authors.initials: PD
authors.lastname: Cleary
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D002908:Chronic Disease; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D015279:Organizational Culture; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014481:United States
references.citation: Ann Intern Med. 2004 Jun 1;140(11):897-901
references.pmid: 15172904
references.citation: Hosp Health Serv Adm. 1996 Summer;41(2):143-59
references.pmid: 10157960
references.citation: N Engl J Med. 1996 Sep 19;335(12):891-4
references.pmid: 8778612
references.citation: Arch Pediatr Adolesc Med. 2005 May;159(5):464-9
references.pmid: 15867121
references.citation: Milbank Q. 1998;76(4):593-624, 510
references.pmid: 9879304
references.citation: Health Serv Res. 2005 Aug;40(4):978-96
references.pmid: 16033488
references.citation: Health Serv Res. 1995 Jun;30(2):377-401
references.pmid: 7782222
references.citation: Med Care. 1991 Mar;29(3):272-82
references.pmid: 1997755
references.citation: Med Care. 2008 May;46(5):489-96
references.pmid: 18438197
references.citation: J Gen Intern Med. 2000 Mar;15(3):163-8
references.pmid: 10718896
references.citation: Med Care. 2001 Jul;39(7 Suppl 1):I62-78
references.pmid: 11488265
references.citation: Qual Saf Health Care. 2002 Dec;11(4):345-51
references.pmid: 12468695
references.citation: Jt Comm J Qual Saf. 2003 Feb;29(2):85-93
references.pmid: 12616923
references.citation: Pediatrics. 2001 Jan;107(1):14-22
references.pmid: 11134428
references.citation: Ann Fam Med. 2005 May-Jun;3(3):200-8
references.pmid: 15928222
references.citation: Med Care. 1996 Sep;34(9):931-53
references.pmid: 8792782
references.citation: Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78
references.pmid: 11816692
references.citation: Milbank Q. 1996;74(4):511-44
references.pmid: 8941260
references.citation: N Engl J Med. 1996 Oct 3;335(14):1060-3
references.pmid: 8793935
references.citation: Am J Infect Control. 1997 Apr;25(2):85-95
references.pmid: 9113283
references.citation: Med Care. 2000 Feb;38(2):207-17
references.pmid: 10659694
references.citation: Ann Intern Med. 2004 Jun 1;140(11):887-96
references.pmid: 15172903
references.citation: BMJ. 2000 Feb 26;320(7234):569-72
references.pmid: 10688568
references.citation: Jt Comm J Qual Saf. 2004 Mar;30(3):152-62
references.pmid: 15032072
references.citation: Milbank Q. 2001;79(2):281-315
references.pmid: 11439467
references.citation: JAMA. 1998 Sep 16;280(11):1000-5
references.pmid: 9749483
references.citation: N Engl J Med. 1989 Jan 5;320(1):53-6
references.pmid: 2909878
references.citation: Diabetes Care. 2004 Jan;27(1):2-8
references.pmid: 14693957
references.citation: Health Serv Res. 2006 Feb;41(1):265-83
references.pmid: 16430611
references.citation: JAMA. 2005 May 18;293(19):2384-90
references.pmid: 15900009
references.citation: N Engl J Med. 2003 Jun 26;348(26):2635-45
references.pmid: 12826639
references.citation: Health Aff (Millwood). 2002 May-Jun;21(3):80-90
references.pmid: 12026006
references.citation: N Engl J Med. 2007 Mar 1;356(9):921-34
references.pmid: 17329699
references.citation: Med Care. 2004 Nov;42(11):1040-8
references.pmid: 15586830