Abstract
BackgroundA key characteristic of healthcare systems that deliver high quality and cost performance in a sustainable way is a systematic approach to capacity and capability building for quality improvement. The aim of this research was to explore the factors that lead to successful implementation of a program of quality improvement projects and a capacity and capability building program that facilitates or support these.MethodsBetween July 2018 and February 2020, the Southern Adelaide Local Health Network (SALHN), a network of health services in Adelaide, South Australia, conducted three capability-oriented capacity building programs that incorporated 82 longstanding individual quality improvement projects. Qualitative analysis of data collected from interviews of 19 project participants and four SALHN Improvement Faculty members and ethnographic observations of seven project team meetings were conducted.ResultsWe found four interacting components that lead to successful implementation of quality improvement projects and the overall program that facilitates or support these: an agreed and robust quality improvement methodology, a skilled faculty to assist improvement teams, active involvement of leadership and management, and a deep understanding that teams matter. A strong safety culture is not necessarily a pre-requisite for quality improvement gains to be made; indeed, undertaking quality improvement activities can contribute to an improved safety culture. For most project participants in the program, the time commitment for projects was significant and, at times, maintaining momentum was a challenge.ConclusionsHealthcare systems that wish to deliver high quality and cost performance in a sustainable way should consider embedding the four identified components into their quality improvement capacity and capability building strategy.
Highlights
A key characteristic of healthcare systems that deliver high quality and cost performance in a sustainable way is a systematic approach to capacity and capability building for quality improvement [2,3,4,5]
There were four themes identified from the analysis of factors that lead to successful historical implementation of Continuous Improvement Program (CIP) projects and the overall Program that facilitates or support these: an agreed and robust Quality improvement (QI) system, a skilled faculty to assist improvement teams, active involvement of leadership and management, and an understanding that teams matter
These are explored in turn, together with another theme from the interviews, the relationship between safety culture and QI, which is followed by barriers to successful improvement projects
Summary
A key characteristic of healthcare systems that deliver high quality and cost performance in a sustainable way is a systematic approach to capacity and capability building for quality improvement [2,3,4,5]. QI capacity and capability building leverages the inherent self-sustaining ability of organisations and systems to recognise, analyse and improve quality issues by controlling and allocating available resources more effectively [2]. Organisations can use these resources to support the delivery of their core strategic priorities, such as improving care pathways, continuously improving, and enhancing access to services by patients [3]. If capacity and capability building in QI is a pre-requisite for high functioning health systems, what are its features when undertaken sustainably and continuously over a period of years?
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