Exploring implementation of quality improvement initiatives in healthcare: a qualitative case study
Date
2010-04-15T15:57:05Z
Authors
Mackelson, Claire A.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Effective implementation of quality improvement (QI) initiatives is associated with enhanced clinical outcomes, increased patient and provider satisfaction, and reduced length of hospital stay. However resources and effort invested in the QI initiatives do not always meet clinical or patient expectations. As a prerequisite for changing this situation the aims of this qualitative study were to examine: (a) the process underlying implementation of QI initiatives in the emergency department (ED); and, (b) the use of an implementation audit checklist to improve performance. This qualitative exploratory study was conducted over a four-week period. Purposive intensity sampling was employed to recruit six ED healthcare providers who were: (a) a male or female ED registered nurse or ED physician; and, (b) involved with designing, planning and implementing QI initiatives in the ED. Numerical and free text data were collected from six implementation audit checklists. Data were also collected from six face-to-face interviews. Findings are consistent with previous studies. Critical features of effective implementation are: prioritization of initiatives; diligence in planning; staff and leadership engagement; on-going evaluation; collaborative teamwork; and, resources. The implementation audit checklist consisting of step-by-step guidelines, definition of capacity and resource allocation is perceived as a promising intervention tool for use by multidisciplinary healthcare professionals. This checklist, a facilitator for transferring implementation theory into operational and clinical practice, has potential to improve emergency department performance.
Description
Keywords
Implementation, Quality Improvement, Checklist, Change Management