Examining Quality Improvement Programs: The Case of Minnesota Hospitals

Abstract

Objective. To determine if there is a hierarchy of improvement program adoption by hospitals and outline that hierarchy. Data Sources. Primary data were collected in the spring of 2007 via e-survey from 210 individuals representing 109 Minnesota hospitals. Secondary data from 2006 were assembled from the Leapfrog database. Study Design. As part of a larger survey, respondents were given a list of improvement programs and asked to identify those programs that are used in their hospital. Data Collection/Data Extraction. Rasch Model Analysis was used to assess whether a unidimensional construct exists that defines a hospital's ability to implement performance improvement programs. Linear regression analysis was used to assess the relationship of the Rasch ability scores with Leapfrog Safe Practices Scores to validate the research findings. Principal Findings. The results of the study show that hospitals have widely varying abilities in implementing improvement programs. In addition, improvement programs present differing levels of difficulty for hospitals trying to implement them. Our findings also indicate that the ability to adopt improvement programs is important to the overall performance of hospitals.Conclusions. There is a hierarchy of improvement programs in the health care context. A hospital's ability to successfully adopt improvement programs is a function of its existing capabilities. As a hospital's capability increases, the ability to successfully implement higher level programs also increases.

A Rasch model analysis of technology usage in Minnesota hospitals

“…A similar finding was made in a study examining the implementation of improvement programs within hospitals [7]. In particular, it was found that differing levels of difficulty existed among the improvement programs themselves.…”

“…Similarly, the Rasch ability parameter (ˇ) conjointly positions the hospitals according to their ability to implement healthcare technologies on the same underlying continuum of technological capability. Further discussion of the Rasch model used in this study can be found in previous research [7,75].…”

Achieving employee commitment for continuous improvement initiatives

“…Continuous improvement, which is the ongoing improvement of products, programs, services, or processes (Blazey, 2006), plays a critical role in a TQM environment (Anderson et al, 1994), and prior research has found that ongoing improvement is one of the most important quality management constructs that lead directly to organizational performance (Olson et al, 2008;Yeung et al, 2005). While there is a substantial body of research that examines the technical aspects of TQM and continuous improvement, only a few studies have examined the role of employee attitudes in contributing to the success of TQM and continuous improvement initiatives.…”

Factors predicting change in hospital safety climate and capability in a multi-site patient safety collaborative: a longitudinal survey study

“…Research suggests that larger hospitals will not implement a programme as effectively as smaller hospitals due to diffusion of programme governance and that hospital teaching status may affect engagement and success in quality improvement 43–45. Programme preconditions such as organisational recognition and knowledge of local safety issues, systems to support improvement and measurement, stability in meeting external targets and availability of resources to support the programme may all lead to enhanced programme outcomes 46 47. Further studies and theory suggest that local experience in programme implementation in terms of the degree of clinician engagement, measurement of process variation, senior management support, programme governance, early adoption of process changes and compatibility with existing targets may be critical factors 29 48–50.…”