title: Quality improvement collaboratives and the wisdom of crowds: spread explained by perceived success at group level.
abstract: BACKGROUND
  Many studies have been conducted to evaluate the impact of quality improvement collaboratives (QICs) on the quality of healthcare. This article addresses an underexplored topic, namely the use of QICs as 'intentional spread strategy.' Its objective is to predict the dissemination of projects within hospitals participating in a change programme based on several QICs. We tested whether the average project success at QIC level (based on opinions of individual project team leaders) explains the dissemination of projects one year later.
  
  
  RESULTS
  After one year, 148 project team leaders of 16 hospitals participating in the two-year programme were asked to rate the success of their improvement project on a scale from 1 to 10. At the end of the second year, the programme coordinator of each hospital provided information on the second-year dissemination. Average success scores and dissemination statistics were calculated for each QIC (N = 12). The non-parametric correlation between team leader judgment and dissemination rate at QIC level is 0.73 (P < 0.01).
  
  
  CONCLUSIONS
  Previous work, focusing on the team and hospital level, showed which factors contributed to local success stories. It also illustrated how successes play a role in dissemination processes within programme hospitals. The current study suggests that we cannot ignore the extent to which the dissemination potential of individual projects is defined by their QIC. Aggregated team leader judgments at the QIC level might predict the future dissemination in participating organizations. The findings, however, need to be replicated in larger, independent samples.
authors.affiliation: NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands. m.duckers@impact.arq.org.|Impact-National knowledge and advice centre for psychosocial care concerning critical incidents, Diemen, The Netherlands. m.duckers@impact.arq.org.
authors.forename: Michel L A
authors.initials: ML
authors.lastname: Dückers
authors.affiliation: NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands. p.groenewegen@nivel.nl.|Department of Sociology, Department of Human Geography, Utrecht University, Utrecht, The Netherlands. p.groenewegen@nivel.nl.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.affiliation: NIVEL-Netherlands Institute for Health Services Research, Utrecht, The Netherlands. c.wagner@nivel.nl.|EMGO Institute for Health and Care Research, Free University Medical Centre, Amsterdam, The Netherlands. c.wagner@nivel.nl.
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
mesh_terms: D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D009936:Organizational Innovation; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*