Critical Success Factors for Performance Improvement Programs

Barron, William M.; Krsek, Cathleen; Weber, Diane; Cerese, Julie

doi:10.1016/s1553-7250(05)31028-2

Cited by 18 publications

(10 citation statements)

References 17 publications

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“…Notably, the Asthma Task Force was built almost entirely from disciplines that are already involved in the care of hospitalized children with asthma (RT, nursing, physicians). The contribution of the asthma compliance officer to the team, a crucial component of successful QI projects, 38 required hospital administration commitment and financial support. Finally, the approach taken by the task force to position physicians with the responsibility for the final review of the HMPC with the caretaker was considered vital to the success of this QI project because it consolidated the information provided by other team members with the highest level of authority.…”

Section: Discussionmentioning

confidence: 99%

Linking Patient-Centered Medical Home and Asthma Measures Reduces Hospital Readmission Rates

et al. 2014

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OBJECTIVE: We sought to achieve 100% compliance with all 3 Children’s Asthma Care (CAC; CAC-1, CAC-2, CAC-3) measures and track attendance at follow-up appointments with the patient-centered medical home. The impact of these measures on readmission and emergency department utilization rates was evaluated. METHODS: This quality improvement study evaluated compliance with CAC measures in pediatric patients aged 2 to 18 years old hospitalized with a primary diagnosis of asthma from January 1, 2008, through June 30, 2012. A multidisciplinary Asthma Task Force was assembled to develop interventions. Attendance at the follow-up appointment was tracked monthly from January 1, 2009. Readmission and emergency department utilization rates were compared between the preimplementation period (January 1, 2006, through December 31, 2007) and the postimplementation period (January 1, 2008, through June 30, 2012). RESULTS: The preimplementation period included 231 subjects and the postimplementation period included 532 subjects. Compliance with CAC-3 was 95% from October 1, 2009, through June 30, 2012. Compliance with the postdischarge follow-up appointment was 69% from January 1, 2009 through September 30, 2009, increasing significantly to 90% from October 1, 2009, through June 30, 2012 (P < .001). Postimplementation readmission rates significantly decreased in the 91- to 180-day postdischarge interval (odds ratio: 0.29; 95% confidence interval: 0.11–0.78). CONCLUSIONS: In children hospitalized with asthma, compliance with the asthma core measures and the postdischarge follow-up appointment with the primary care provider was associated with reduced readmission rates at 91 to 180 days after discharge. We attribute our results to a comprehensive set of interventions designed by our multidisciplinary Asthma Task Force.

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Section: Discussionmentioning

confidence: 99%

Linking Patient-Centered Medical Home and Asthma Measures Reduces Hospital Readmission Rates

et al. 2014

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“…Instead of a single-level change approach, the literature suggests a strategy that involves actors at all organisational layers--from physicians and nurses to management and executives [17-20]. The MQC designers shared this perspective and included a leadership programme.…”

Section: Introductionmentioning

confidence: 99%

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

et al. 2011

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BackgroundBetween 2004 and 2008, 24 Dutch hospitals participated in a two-year multilevel quality collaborative (MQC) comprised of (a) a leadership programme for hospital executives, (b) six quality-improvement collaboratives (QICs) for healthcare professionals and other staff, and (c) an internal programme organisation to help senior management monitor and coordinate team progress. The MQC aimed to stimulate the development of quality-management systems and the spread of methods to improve patient safety and logistics. The objective of this study is to describe how the first group of eight MQC hospitals sustained and disseminated improvements made and the quality methods used.MethodsThe approach followed by the hospitals was described using interview and questionnaire data gathered from eight programme coordinators.ResultsMQC hospitals followed a systematic strategy of diffusion and sustainability. Hospital quality-management systems are further developed according to a model linking plan-do-study-act cycles at the unit and hospital level. The model involves quality norms based on realised successes, performance agreements with unit heads, organisational support, monitoring, and quarterly accountability reports.ConclusionsIt is concluded from this study that the MQC contributed to organisational development and dissemination within participating hospitals. Organisational learning effects were demonstrated. System changes affect the context factors in the theory of organisational readiness: organisational culture, policies and procedures, past experience, organisational resources, and organisational structure. Programme coordinator responses indicate that these factors are utilised to manage spread and sustainability. Further research is needed to assess long-term effects.

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“…Our study echoes current implementation literature demonstrating the clear importance of leadership in improvement efforts. Effective and engaged leadership was another important characteristic noted by respondents and one that has been shown to be a critical aspect of successful QI in other studies . CEOs and senior administrative personnel need to be engaged, motivating, and seen to be supporting frontline staff activities .…”

Section: Discussionmentioning

confidence: 86%

Ontario's Emergency Department Process Improvement Program: The Experience of Implementation

Rotteau

Webster

Salkeld

et al. 2015

Academic Emergency Medicine

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ObjectivesIn recent years, Lean manufacturing principles have been applied to health care quality improvement efforts to improve wait times. In Ontario, an emergency department (ED) process improvement program based on Lean principles was introduced by the Ministry of Health and Long‐Term Care as part of a strategy to reduce ED length of stay (LOS) and to improve patient flow. This article aims to describe the hospital‐based teams’ experiences during the ED process improvement program implementation and the teams’ perceptions of the key factors that influenced the program's success or failure.MethodsA qualitative evaluation was conducted based on semistructured interviews with hospital implementation team members, such as team leads, medical leads, and executive sponsors, at 10 purposively selected hospitals in Ontario, Canada. Sites were selected based, in part, on their changes in median ED LOS following the implementation period. A thematic framework approach as used for interviews, and a standard thematic coding framework was developed.ResultsTwenty‐four interviews were coded and analyzed. The results are organized according to participants’ experience and are grouped into four themes that were identified as significantly affecting the implementation experience: local contextual factors, relationship between improvement team and support players, staff engagement, and success and sustainability. The results demonstrate the importance of the context of implementation, establishing strong relationships and communication strategies, and preparing for implementation and sustainability prior to the start of the project.ConclusionsSeveral key factors were identified as important to the success of the program, such as preparing for implementation, ensuring strong executive support, creation of implementation teams based on the tasks and outcomes of the initiative, and using multiple communication strategies throughout the implementation process. Explicit incorporation of these factors into the development and implementation of future similar interventions in health care settings could be useful.

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Critical Success Factors for Performance Improvement Programs

Cited by 18 publications

References 17 publications

Linking Patient-Centered Medical Home and Asthma Measures Reduces Hospital Readmission Rates

Linking Patient-Centered Medical Home and Asthma Measures Reduces Hospital Readmission Rates

Understanding organisational development, sustainability, and diffusion of innovations within hospitals participating in a multilevel quality collaborative

Ontario's Emergency Department Process Improvement Program: The Experience of Implementation

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