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Evaluation of Organizational Culture among Different Levels of Healthcare Staff Participating in the Institute for Healthcare Improvement's 100,000 Lives Campaign

Published online by Cambridge University Press:  02 January 2015

Ronda L. Sinkowitz-Cochran*
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
Amanda Garcia-Williams
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
Andrew D. Hackbarth
Affiliation:
Institute for Healthcare Improvement, Cambridge, Massachusetts
Bonnie Zell
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
G. Ross Baker
Affiliation:
Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
C. Joseph McCannon
Affiliation:
Institute for Healthcare Improvement, Cambridge, Massachusetts
Elise M. Beltrami
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
John A. Jernigan
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
L. Clifford McDonald
Affiliation:
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, Atlanta, Georgia
Donald A. Goldmann
Affiliation:
Institute for Healthcare Improvement, Cambridge, Massachusetts Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
*
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, 1600 Clifton Road MS A-31, Atlanta, GA 30333 (rls7@cdc.gov)

Abstract

Background.

Little is known about how hospital organizational and cultural factors associated with implementation of quality initiatives such as the Institute for Healthcare Improvement's (IHI) 100,000 Lives Campaign differ among levels of healthcare staff.

Design.

Evaluation of a mixed qualitative and quantitative methodology (“trilogic evaluation model”).

Setting.

Six hospitals that joined the campaign before June 2006.

Participants.

Three strata of staff (executive leadership, midlevel, and frontline) at each hospital.

Results.

Surveys were completed in 2008 by 135 hospital personnel (midlevel, 43.7%; frontline, 38.5%; executive, 17.8%) who also participated in 20 focus groups. Overall, 93% of participants were aware of the IHI campaign in their hospital and perceived that 58% (standard deviation, 22.7%) of improvements in quality at their hospital were a direct result of the campaign. There were significant differences between staff levels on the organizational culture (OC) items, with executive-level staff having higher scores than midlevel and frontline staff. All 20 focus groups perceived that the campaign interventions were sustainable and that data feedback, buy-in, hardwiring (into daily activities), and leadership support were essential to sustainability.

Conclusions.

The trilogic model demonstrated that the 3 levels of staff had markedly different perceptions regarding the IHI campaign and OC. A framework in which frontline, midlevel, and leadership staff are simultaneously assessed may be a useful tool for future evaluations of OC and quality initiatives such as the IHI campaign.

Infect Control Hosp Epidemiol 2012;33(2):135-143

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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