Factors that shape the development of interprofessional improvement initiatives in health organisations

Greenfield, D; Nugus, P; Travaglia, J; Braithwaite, J

Factors that shape the development of interprofessional improvement initiatives in health organisations

Greenfield, D Nugus, P Travaglia, J

Braithwaite, J

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Publication Type:: Journal Article
Citation:: BMJ Quality and Safety, 2011, 20 (4), pp. 332 - 337
Issue Date:: 2011-04-01

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Field	Value	Language
dc.contributor.author	Greenfield, D	en_US
dc.contributor.author	Nugus, P	en_US
dc.contributor.author	Travaglia, J https://orcid.org/0000-0002-7537-0466	en_US
dc.contributor.author	Braithwaite, J	en_US
dc.date.issued	2011-04-01	en_US
dc.identifier.citation	BMJ Quality and Safety, 2011, 20 (4), pp. 332 - 337	en_US
dc.identifier.issn	2044-5415	en_US
dc.identifier.uri	http://hdl.handle.net/10453/117907
dc.description.abstract	Background: Quality and safety improvement programmes advance the standard of care delivered by health organisations but have been shown to be less effective than anticipated. Implementing improvement programmes require a greater understanding of the impact of the social context and strategies that engage staff. Objective: To investigate factors that shaped the development of interprofessional improvement initiatives in a health organisation. Methods: Data are drawn from a large-scale longitudinal action research study examining interprofessional learning and practice. The setting is an autonomous bounded health jurisdiction in Australia. Within the study, health professionals have conceptualised more than 111 interprofessional improvement projects, of which 76 have evolved into ongoing activities. Textual data were analysed using emergent coding and descriptive statistics. Results: Initiatives were shaped by six determinants: site receptivity; team issues; leadership; impact on healthcare relations; impact on quality and safety issues; and extent to which the projects became institutionally embedded. Initiatives that engaged participants and progressed were characterised by and displayed flexible leadership, and ongoing refinement and maturity over time. The local organisational context and initiatives coevolved. Conclusions: Improvement initiatives are necessary for improved quality of care and patient safety but are difficult to implement and sustain. The factors identified to develop them are constantly under challenge in health services. Improving healthcare quality will, in part, depend upon the ability to provide more flexible and supportive social contexts.	en_US
dc.relation.ispartof	BMJ Quality and Safety	en_US
dc.relation.isbasedon	10.1136/bmjqs.2010.044545	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Longitudinal Studies	en_US
dc.subject.mesh	Leadership	en_US
dc.subject.mesh	Interprofessional Relations	en_US
dc.subject.mesh	Safety Management	en_US
dc.subject.mesh	Staff Development	en_US
dc.subject.mesh	Organizational Culture	en_US
dc.subject.mesh	Delivery of Health Care	en_US
dc.subject.mesh	Quality of Health Care	en_US
dc.title	Factors that shape the development of interprofessional improvement initiatives in health organisations	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	20	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1302 Curriculum and Pedagogy	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	20	en_US

Abstract:

Background: Quality and safety improvement programmes advance the standard of care delivered by health organisations but have been shown to be less effective than anticipated. Implementing improvement programmes require a greater understanding of the impact of the social context and strategies that engage staff. Objective: To investigate factors that shaped the development of interprofessional improvement initiatives in a health organisation. Methods: Data are drawn from a large-scale longitudinal action research study examining interprofessional learning and practice. The setting is an autonomous bounded health jurisdiction in Australia. Within the study, health professionals have conceptualised more than 111 interprofessional improvement projects, of which 76 have evolved into ongoing activities. Textual data were analysed using emergent coding and descriptive statistics. Results: Initiatives were shaped by six determinants: site receptivity; team issues; leadership; impact on healthcare relations; impact on quality and safety issues; and extent to which the projects became institutionally embedded. Initiatives that engaged participants and progressed were characterised by and displayed flexible leadership, and ongoing refinement and maturity over time. The local organisational context and initiatives coevolved. Conclusions: Improvement initiatives are necessary for improved quality of care and patient safety but are difficult to implement and sustain. The factors identified to develop them are constantly under challenge in health services. Improving healthcare quality will, in part, depend upon the ability to provide more flexible and supportive social contexts.

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http://hdl.handle.net/10453/117907