An intraorganizational model for developing and spreading quality improvement innovations
| Autor: | Lindsay A Gainer, Adrienne S Allen, Katherine C. Kellogg, Sara J. Singer, Tatum OʼSullivan |
|---|---|
| Přispěvatelé: | Sloan School of Management, Kellogg, Katherine C. |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Quality management
Process management Leadership and Management Process (engineering) Download Strategy and Management spread 03 medical and health sciences primary care 0302 clinical medicine Medicine Humans Operations management Performance measurement 030212 general & internal medicine implementation Dissemination License Features Anthropology Cultural Primary Health Care business.industry 030503 health policy & services Health Policy Quality Improvement Organizational Innovation patient-centered medical home (PCMH) Workflow Models Organizational Organizational structure 0305 other medical science business |
| Zdroj: | Health Care Management Review Lippincott, Williams and Wilkins |
| ISSN: | 1550-5030 0361-6274 |
| Popis: | BACKGROUND Recent policy reforms encourage quality improvement (QI) innovations in primary care, but practitioners lack clear guidance regarding spread inside organizations. PURPOSE We designed this study to identify how large organizations can facilitate intraorganizational spread of QI innovations. METHODOLOGY/APPROACH We conducted ethnographic observation and interviews in a large, multispecialty, community-based medical group that implemented three QI innovations across 10 primary care sites using a new method for intraorganizational process development and spread. We compared quantitative outcomes achieved through the group's traditional versus new method, created a process model describing the steps in the new method, and identified barriers and facilitators at each step. FINDINGS The medical group achieved substantial improvement using its new method of intraorganizational process development and spread of QI innovations: standard work for rooming and depression screening, vaccine error rates and order compliance, and Pap smear error rates. Our model details nine critical steps for successful intraorganizational process development (set priorities, assess the current state, develop the new process, and measure and refine) and spread (develop support, disseminate information, facilitate peer-to-peer training, reinforce, and learn and adapt). Our results highlight the importance of utilizing preexisting organizational structures such as established communication channels, standardized roles, common workflows, formal authority, and performance measurement and feedback systems when developing and spreading QI processes inside an organization. In particular, we detail how formal process advocate positions in each site for each role can facilitate the spread of new processes. PRACTICE IMPLICATIONS Successful intraorganizational spread is possible and sustainable. Developing and spreading new QI processes across sites inside an organization requires creating a shared understanding of the necessary process steps, considering the barriers that may arise at each step, and leveraging preexisting organizational structures to facilitate intraorganizational process development and spread.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially. |
| Databáze: | OpenAIRE |
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