Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administratorsʼ Perspectives

Kash, Bita A.; Spaulding, Aaron; Johnson, Christopher; Gamm, Larry

doi:10.1097/00115514-201401000-00011

Cited by 56 publications

(52 citation statements)

References 15 publications

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“…This phenomenon has been previously observed in the radiology setting(29) and should be taken into account during quality improvement initiatives using informatics tools. According to healthcare administrators, the most important success factors for the implementation of change initiatives are alignment of culture and values between individuals and departments; organization’s mission, vision and values; operational activities within the organization and definition of how processes should work; and engagement of people(30). …”

Section: Discussionmentioning

confidence: 99%

Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

et al. 2015

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Rationale and Objectives Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve.

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Section: Discussionmentioning

confidence: 99%

Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

et al. 2015

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“…For example, Decker et al (2012) created a list of critical failure factors of changes. On the other hand, Kash (2014) describes success factors of changes based on existing models of changes. Many authors describe these factors differently.…”

Section: Introductionmentioning

confidence: 99%

Examination of Factors Affecting the Implementation of Organizational Changes

Dobrovič¹,

Timková²

2017

JOC

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Organizational changes have a major impact on the competitiveness, growth, efficiency, and survival of any organization. This article deals with the issue of an organizational change and its management. The main objective of the research is to verify the existence of a statistically significant relationship between selected factors and the success of organizational changes in Slovak companies. In the short theoretical introduction, the article explains basic aspects of change management. The main part of the article deals with the analysis of variables affecting the outcome of changes taking place in companies. The empirical survey was carried out using the questionnaire method. The questionnaire was distributed to employees from different types of companies where the changes took place. The survey sample consists of 287 respondents. To test the statistical hypotheses, we used the Spearman's correlation coefficient. The test hypotheses were processed through the program Gretl. Based on the tested relationship between the variables, a significant relationship between the variables was found -the time needed to prepare and implement the change and the success of the change. Other variables also showed an impact on the final outcome of the change. It has been shown that the process of planning changes, checking upon changes, and the time needed to implement changes have an important role and a major effect on the ultimate success or failure of change in a company.

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“…Within the management literature, successful implementation of the change initiative or process improvement is a heated topic, but this topic is seldom discussed in health care process improvement, and only a few studies have explored this topic. Kash and colleagues [17] identi ed 10 speci c success factors in the implementation of change initiatives after interviews were conducted with 61 health care leaders in 2 large systems. The top 3 success factors were culture and values, business processes, and people engagement [17].…”

Section: Discussionmentioning

confidence: 99%

“…Kash and colleagues [17] identi ed 10 speci c success factors in the implementation of change initiatives after interviews were conducted with 61 health care leaders in 2 large systems. The top 3 success factors were culture and values, business processes, and people engagement [17]. Another study focused on 167 front-line leaders from 4 community hospitals to explore why hospital change efforts fail and to identify 10 primary barriers to successful hospital change, such as poor implementation, short time lines, lack of support for the project, weak leadership, suspicion toward upper management, unrealistic plans, and communication problems [18].…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Global Quality Improvement Project in 20 Countries: A Case Study

Coville

Barwise

Kashyap

et al. 2019

Preprint

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Background: The Checklist for Early Recognition and Treatment of Acute Illness and Injury (CERTAIN) study is a before-and-after clinical quality improvement study involving 20 countries. Our aim was to describe the challenges and solutions for study implementation across various intensive care units.Methods: After local institutional review board approval, each study center had a setup period before patient data were collected. Each center was required to accomplish 4 stages: baseline data collection, remote simulation training, local implementation, and postimplementation data collection and maintenance of process of care. We measured the time required to complete each study stage and used the Define, Measure, Analyze, Improve, and Control (DMAIC) framework to identify the challenges encountered during each stage and guide improvement strategies to facilitate implementation of CERTAIN.Results: Between June 2012 and December 2017, 55 centers from 20 countries were recruited to participate. The time to complete each stage at different centers varied significantly. The most common domains in which challenges occurred were 1) leadership support and team building, 2) communication, 3) work environment culture, 4) language barriers, 5) infrastructure and technology, and 6) sustainability. Obstacles in these 6 areas delayed reaching major milestones of the study. Different strategies were deployed to overcome these barriers: engaging leadership for support, using native-speaking clinicians during training sessions, using various communication platforms, providing personal computers to local hospitals, making in-person site visits, offering flexible training time, and supporting local centers’ grant applications. Centers that enrolled during the control phase, compared with those that enrolled earlier, had significantly shorter times and less variation in times for each study stage and for the total study time.Conclusions: By using the DMAIC method, we identified the predominant 6 domains in which challenges occurred during implementation of the global CERTAIN study and developed targeted strategies to overcome the challenges and shorten the duration of the study. The DMAIC method would be useful in improving the efficiency of other large-scale multinational quality improvement projects.

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Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administratorsʼ Perspectives

Cited by 56 publications

References 15 publications

Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

Examination of Factors Affecting the Implementation of Organizational Changes

Implementation of a Global Quality Improvement Project in 20 Countries: A Case Study

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