Abstract
Background: The failure of quality improvement projects has been a global issue that exists within different geographical and organisational contexts. The case of this in the healthcare sector is more obvious, given the complex and contingent characteristics of healthcare organisations. For this reason, healthcare settings require more deliberate thought and extensive efforts to sustain the gains of quality improvement. Within the context of Saudi Arabia, the Ministry of Health (MOH) has long been introducing a number of improvement initiatives and quality accreditation projects to improve hospitals’ performance. These efforts represent precious investments that are supposed to sustain and flourish over time. Summary: The sustainability of the improvement initiatives within the MOH hospitals is still the main struggle. This challenge requires a more holistic analysis that exceeds hospitals’ boundaries by considering the external influences that undermine the capability of these hospitals to sustain the improvement. The institutional environment is one of the most critical dimensions that need to be explored prior to implementing quality improvement initiatives. Understanding the institutional characteristics provides significant overview of the regulatory powers that affect the implementation of quality improvement initiatives within healthcare organisations. Key Messages: An institutional perspective has been employed in this study to provide an overview of the external institutional influences that affect the sustainability of improvement initiatives. This study establishes a baseline for further debate on the mediating role of the institutional powers in determining the sustainability level of quality improvement initiatives within the healthcare sector.
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