Improving the Context Supporting Quality Improvement in a Neonatal Intensive Care Unit Quality Collaborative: An Exploratory Field Study.
Successful quality improvement (QI) requires a supportive context. The goal was to determine whether a structured curriculum could help QI teams improve the context supporting their QI work. An exploratory field study was conducted of 43 teams participating in a neonatal intensive care unit QI collaborative. Using a curriculum based on the Model for Understanding Success in Quality, teams identified gaps in their context and tested interventions to modify context. Surveys and self-reflective journals were analyzed to understand how teams developed changes to modify context. More than half (55%) targeted contextual improvements within the microsystem, focusing on motivation and culture. "Information sharing" interventions to communicate information about the project as a strategy to engage more staff were the most common interventions tested. Further study is needed to determine if efforts to modify context consistently lead to greater outcome improvements.
1 Case Western Reserve University, Cleveland, OH.|2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Heather R
HR
Grooms
2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH.|3 University of Cincinnati, Cincinnati, OH.
Craig M
CM
Froehle
4 Associates in Process Improvement, Austin, TX.
Lloyd P
LP
Provost
5 Improvision Healthcare, Inc., Lucan, Ontario, Canada.|6 Vermont Oxford Network, Burlington, VT.|7 University of Toronto, Toronto, Ontario, Canada.
James
J
Handyside
2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Heather C
HC
Kaplan
D003299:Cooperative Behavior; D003479:Curriculum; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000592:standards; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D058996:Quality Improvement / Q000458:organization & administration*; D013192:Staff Development / Q000458:organization & administration*
Model for Understanding Success in Quality; Vermont Oxford Network; context; organizational models; quality improvement