Medical engagement in organisation-wide safety and quality-improvement programmes: experience in the UK Safer Patients Initiative.
OBJECTIVE
To identify factors affecting doctors' engagement with the Safer Patients Initiative (SPI).


METHODS
Qualitative interview study.


METHODS
Four organisations participating in phase 1 of the SPI programme, from four different geographical locations in the UK.


METHODS
34 staff members, comprising senior executive/management leads involved in the SPI programme, the principal SPI programme coordinator and the operational leads in each of the SPI clinical work areas.


METHODS
Staff perceptions of issues affecting medical engagement with SPI, identified in the interviews.


RESULTS
Qualitative analysis identified seven factors that were reported to affect medical engagement with the SPI programme: (1) Organisation Track Record in QSI, (2) Resource Availability & Allocation, (3) Perceptions of the purpose of SPI, (4) Evidence of Efficacy of Programme, (5) External Expertise, (6) Local Programme Champions and (7) Managers Involvement. Specific barriers and general enabling strategies were identified and described for each factor, based upon participants' experiences.


CONCLUSIONS
Medical engagement is a complex technical, socio-political and motivational issue that is underpinned by a series of inter-related factors associated with the organisational context, the design of improvement programmes and how they are implemented and promoted. Healthcare organisations planning to embark on safety and quality-improvement programmes may benefit from systematically addressing the core themes identified by this study, in order to promote optimal medical engagement.
Department of Surgery and Cancer, Imperial College London, Rm 503, 5th Floor Wright Fleming Building, St Mary's Campus, Norfolk Place, London W2 1PG, UK. a.parand@imperial.ac.uk
Anam
A
Parand
Susan
S
Burnett
Jonathan
J
Benn
Sandra
S
Iskander
Anna
A
Pinto
Charles
C
Vincent
D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D017751:Safety Management; D006113:United Kingdom