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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

  • Ronda L. Sinkowitz-Cochran (a1), Amanda Garcia-Williams (a1), Andrew D. Hackbarth (a2), Bonnie Zell (a1), G. Ross Baker (a3), C. Joseph McCannon (a2), Elise M. Beltrami (a1), John A. Jernigan (a1), L. Clifford McDonald (a1) and Donald A. Goldmann (a2) (a4)...
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

Copyright
Corresponding author
Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion, 1600 Clifton Road MS A-31, Atlanta, GA 30333 (rls7@cdc.gov)
References
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1.Kohn KT, Corrigan JM, Donaldson MS. To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press, 1999.
2.Kuehn B. AHRQ: US quality of care falls short. JAMA 2009;301:24272428.
3.Weiner BJ, Alexander JA, Baker LC, Shortell SM, Becker M. Quality improvement implementation and hospital performance on patient safety indicators. Med Care Res Rev 2006;63:2956.
4.Shortell SM, Bennett CL, Byck GR. Assessing the impact of continuous quality improvement on clinical practice: what it will take to accelerate progress. Milbank Q 1998;76:593624.
5.Leape LL, Berwick DM. Five years after “To Err Is Human”: what have we learned? JAMA 2005;293:22842390.
6.Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100,000 Lives Campaign: setting a goal and a deadline for improving health care quality. JAMA 2006;295:324327.
7.McCannon CJ, Hackbarth AD, Griffin FA. Miles to go: an introduction to the 5 Million Lives Campaign. Jt Comm J Qual Patient Saf 2007;33:477484.
8.Wang MC, Hyun JK, Shortell SM, Fraser I. Redesigning health systems for quality: lessons from emerging practices. Jt Comm J Qual Patient Saf 2006;32:599611.
9.Baker KA. Chapter 11: Organizational Culture. http://www.au.af.mil/au/awc/awcgate/doe/benchmark/ch11.pdf. Accessed June 1, 2009.
10.Leape LL. Errors in medicine. Clin Chim Acta 2009;104:25.
11.Keroack MA, Youngberg BJ, Cerese JL, Krsek C, Prellwitz LW, Trevelyan EW. Organizational factors associated with high performance in quality and safety in academic medical centers. Acad Med 2007;82:11781186.
12.Lipshutz AKM, Fee C, Schell J, et al. Strategies for success: a PDSA analysis of three QI initiatives in critical care. Jt Comm J Qual Patient Saf 2008;34:435444.
13.Blake SC, Kohler S, Rask K, Davis A, Naylor DV. Facilitators and barriers to 10 National Quality Forum safe practices. Am J Med Qual 2006;21:323334.
14.Grol R, Wensing M. What drives change? barriers to and incentives for achieving evidence-based practice. Med J Aust 2004;180:S57S60.
15.Goeschel CA, Bourgault A, Palleschi M, et al. Nursing lessons from the MHA keystone ICU project: developing and implementing and innovative approach to patient safety. Crit Care Nurs Clin N Am 2006;18:481492.
16.Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355:27252732.
17.Vaughn T, Koepke M, Kroch E, Lehrman W, Sinha S, Levey S. Engagement of leadership in quality improvement initiatives: executive quality improvement survey results. J Patient Saf 2006;2:29.
18.Levey S, Vaughn T, Koepke M, Moore D, Lehrman W, Sinha S. Hospital leadership and quality improvement: rhetoric versus reality. J Patient Saf 2007;3:915.
19.Ohman-Strickland P, Orzano J, Nutting P, et al. Measuring organizational attributes of primary care practices: development of a new instrument. Health Serv Res 2007;42:12571273.
20.Webster CS, Anderson DJ. A practical guide to the implementation of an effective incident reporting scheme to reduce medication error on the hospital ward. Int J Nurs Pract 2002;8:176183.
21.Pronovost PJ, Berenholtz SM, Goeschel C, Thorn I, Waston SR, Holzmueller CG. Improving patient safety in intensive care units in Michigan. J Crit Care 2008;23:207221.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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