New Research from Joseph Restuccia Finds Hospital Leadership Important for Quality Improvement
From Restuccia, J., Mohr, D., Meterko, M., Stolzmann, K., Kaboli, P., (2014). The Association of Hospital Characteristics and Quality Improvement Activities in Inpatient Medical Services. Journal of General Internal Medicine, 5(29), 715-722.
All eyes have been on health care in the US as of late, with the quality of its services under much scrutiny. Deficiencies in patient care have been well reported and documented, but knowledge is scant about the degree to which hospitals are implementing systematic actions or practices to remedy the situation.
A new paper by Joseph Restuccia, Boston University School of Management professor of operations and technology management and dean’s research fellow, investigates the extent to which hospitals are engaging in quality improvement activities (QIAs), or factors influencing the extent of QIAs—data-guided activities designed to bring about immediate improvement in health care delivery. Co-authored by David Mohr, Mark Meterko, Kelly Stolzmann, and Peter Kaboli, the paper, “The Association of Hospital Characteristics and Quality Improvement Activities in Inpatient Medical Services,” appears this month in the Journal of General Internal Medicine.
The group specifically sought to identify the level of QIAs in the Veterans Administration’s (VA) 124 acute care hospitals, as well as factors associated with widespread adoption of QIAs, particularly the use of hospitalists (physicians who specialize in the practice of hospital medicine), non-physician providers, and the extent of goal alignment between senior managers and the inpatient service on commitment to quality. They identified 27 QIAs and classify them in three separate domains:
- Prevention: activities to prevent adverse reactions among patients, such as contracting bedsores or other infections
- Information-gathering: activities to improve the hospital’s knowledge base to improve quality, such as learning best practices within or outside industry, or conducting a management walkaround to raise awareness of the state of the institution
- Infrastructure: the basis on which you can build quality improvement programs and evidence-based practice guidelines; clinicians meet to discuss a topic of interest
Their study of the VA, the largest integrated health system in the US, resulted in three major findings. First, of the three domains, VA hospitals have devoted the most substantial effort to prevention-related QIAs to date. Second, where there is a close alignment of goals between senior managers and inpatient medical service leadership, there is a greater likelihood of QIA use. Finally, medical centers that employ hospitalists display the highest QIA-adoption rates across all three categories.
For senior leaders and clinicians, a key takeaway from the study is the importance of effectively communicating goals and aligning them throughout the organization, a significant factor in improving quality of care.
Read “The Association of Hospital Characteristics and Quality Improvement Activities in Inpatient Medical Services” here.