Impacts of organizational context on quality improvement

• Published in: American journal of medical quality Vol. 28; no. 3; p. 196
• Main Authors: Glasgow, Justin M, Yano, Elizabeth M, Kaboli, Peter J
• Format: Journal Article
• Language: English
• Published: United States 01.05.2013
• Subjects: Cooperative Behavior; Data Mining; Decision Trees; Hospital Administration; Hospitals - standards; Hospitals, Veterans - organization & administration; Hospitals, Veterans - standards; Humans; Models, Organizational; Quality Improvement - organization & administration; United States; United States; Veterans Affairs; organizational characteristics; data mining; quality improvement
• ISSN: 1555-824X
• DOI: 10.1177/1062860612456730

Variation in how hospitals perform on similar quality improvement (QI) efforts argues for a need to understand how different organizational characteristics affect QI performance. The objective of this study was to use data-mining methods to evaluate relationships between measures of organizational characteristics and hospital QI performance. Organizational characteristics were extracted from 2 surveys and analyzed in 3 separate decision-tree models. The decision trees did not find any predictive associations in this sample of 100 hospitals participating in a national QI collaborative. Further model review identified that measures of QI Experience were associated with an ability to make improvements, whereas measures of Staffing and Culture were associated with an ability to sustain improvements. A key area for future research is to understand the challenges faced as QI teams transition from improving care to sustaining quality and to ascertain what organizational characteristics can best overcome those challenges.