title: The Relationship of Engagement in Improvement Practices to Outcome Measures in Large-Scale Quality Improvement Initiatives.
abstract: Hospital engagement networks (HENs) are part of the largest health care improvement initiative ever undertaken. This article explores whether engagement in improvement activities within a HEN affected quality measures. Data were drawn from 1174 acute care hospitals. A composite quality score was created from 10 targeted topic area measures multiplied by the number of qualifying topics. Scores improved from 5.4 (SD = 6.8) at baseline to 4.6 (5.9) at remeasurement; P < .0001. Hospitals with higher baseline scores demonstrated greater improvement ( P < .0001) than hospitals with lower baseline scores. Hospitals with larger Medicaid populations ( P = .023) and micropolitan ( P = .034) hospitals tended to have greater improvement, whereas hospitals in the West ( P = .0009) did not improve as much as hospitals in other regions. After adjusting for hospital characteristics, hospitals with improvement champions ( P = .008), a higher level of engagement with their state association ( P = .001), and more leadership involvement ( P = .005) in HEN demonstrated greater improvement.
authors: 1 Health Research and Educational Trust, Chicago, IL.
authors: Gregory L
authors: GL
authors: Foster
authors: 1 Health Research and Educational Trust, Chicago, IL.
authors: Kevin
authors: K
authors: Kenward
authors: 1 Health Research and Educational Trust, Chicago, IL.
authors: Stephen
authors: S
authors: Hines
authors: 1 Health Research and Educational Trust, Chicago, IL.
authors: Maulik S
authors: MS
authors: Joshi
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007857:Leadership; D008484:Medicaid / Q000706:statistics & numerical data; D015279:Organizational Culture; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D014481:United States
keywords: engagement; hospital; quality improvement; quality measures