Appreciative Inquiry for quality improvement in primary care practices
| Autor: | Caroline A. Carter, Sharon M. Weyer, David Litaker, Casey Schroeder, Kurt C. Stange, James Joseph Werner, Ronald E. Fry, Laura Wu, Sarah Bobiak, Stephen J. Zyzanski, Mary C. Ruhe |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Health (social science) Quality management Appreciative inquiry Leadership and Management MEDLINE Constructive Article law.invention Sex Factors Randomized controlled trial Nursing law Health care Medicine Humans Care Planning Motivation Primary Health Care business.industry Health Policy Racial Groups Age Factors Middle Aged Quality Improvement Checklist Primary Prevention Leadership Observational study Female sense organs business |
| Zdroj: | Quality management in health care. 20(1) |
| ISSN: | 1550-5154 |
| Popis: | Purpose To test the effect of an Appreciative Inquiry (AI) quality improvement strategy on clinical quality management and practice development outcomes. Appreciative inquiry enables the discovery of shared motivations, envisioning a transformed future, and learning around the implementation of a change process. Methods Thirty diverse primary care practices were randomly assigned to receive an AI-based intervention focused on a practice-chosen topic and on improving preventive service delivery (PSD) rates. Medical-record review assessed change in PSD rates. Ethnographic field notes and observational checklist analysis used editing and immersion/crystallization methods to identify factors affecting intervention implementation and practice development outcomes. Results The PSD rates did not change. Field note analysis suggested that the intervention elicited core motivations, facilitated development of a shared vision, defined change objectives, and fostered respectful interactions. Practices most likely to implement the intervention or develop new practice capacities exhibited 1 or more of the following: support from key leader(s), a sense of urgency for change, a mission focused on serving patients, health care system and practice flexibility, and a history of constructive practice change. Conclusions An AI approach and enabling practice conditions can lead to intervention implementation and practice development by connecting individual and practice strengths and motivations to the change objective. |
| Databáze: | OpenAIRE |
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