An evaluation of a frontline led quality improvement initiative: Barriers and facilitators to its success as part of a new quality management framework
Abstract
Purpose
The Edmonton Zone, one of five Zones in Alberta Health Services (the health system in the province of Alberta, Canada), established a quality management framework (QMF) as a means to improve the delivery of high quality health care in the spring of 2014. The purpose of this research study was to understand the factors that facilitated or hindered the implementation of a quality improvement (QI) initiative for hand hygiene led by a newly formed frontline unit quality council (UQC), a part of the QMF, based out of the pediatric intensive care unit (PICU) at the Stollery Children’s Hospital in the Edmonton Zone. This research will provide an understanding of the newly established QMF in the Edmonton Zone and the factors needed to foster the ongoing development of frontline UQC that do improvement work as part of their daily routine.
Design/methodology/approach
Using a qualitative case study research design data were collected using semi-structured open-ended interviews with six key stakeholders (one registered nurse, one physician, one patient case manager, medical director for QI, clinical QI consultant and director of clinical QI) involved in UQC at the PICU.
Findings
Individual, unit and organizational level factors were identified as influencing the function of the UQC. Leadership and work culture were the key facilitating factors to success and lack of QI training and personnel/dedicated time were perceived barriers to completing the QI initiative.
Originality/value
The findings from this research illustrate that frontline UQC are able to impact positive sustained change early in their establishment as part of a larger QMF. It is important, however, for the system to foster ongoing development of capacity and capability of these frontline UQC to ensure sustained success of the larger systems change.
Keywords
Acknowledgements
The authors would like to acknowledge the Integrated Quality Management team from the Edmonton Zone at Alberta Health Services, particularly the clinical quality consultants (Hannah Rempel and Susan Silverthorne) who helped to recruit participants for this study. They would also like to acknowledge those leading the QMF development for providing me with information for the purpose of this paper. The primary author would like to acknowledge Alberta Innovates Health Solutions, Women and Children’s Health Research Institute and KT Canada for supporting her doctoral studies.
Citation
Flynn, R. and Hartfield, D. (2016), "An evaluation of a frontline led quality improvement initiative: Barriers and facilitators to its success as part of a new quality management framework", Leadership in Health Services, Vol. 29 No. 4, pp. 402-414. https://doi.org/10.1108/LHS-11-2015-0039
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited