Creating a Quality-Improvement Dialogue: Utilizing Knowledge From Frontline Staff, Managers, and Experts to Foster Health Care Quality Improvement
Abstract
There is a growing consensus that a hybrid of two common approaches to quality improvement (QI), local participatory QI and expert QI, might be the best method for achieving quality care. Achieving such a hybrid requires that content experts establish an ongoing dialogue with both frontline staff members and managers. In this study we examined frontline staff members' and managers' preferences regarding how to conduct such a dialogue, and we provide practical suggestions for implementation. The two groups shared a number of preferences (e.g., verbal face-to-face exchanges, discussions focused on quality of care). There were also some differences. For example, although managers were interested in discussions of business aspects (e.g., costs), frontline staff members were concerned with workload issues. Finally, although informants acknowledged that engaging in a QI dialogue was time consuming, they also believed it was essential if health care organizations are to improve the quality of care they provide.
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This local participatory approach enhances sustainability efforts.
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- Authors
- Parker, L. E., Kirchner, J. E., Bonner, L. M., Fickel, J. J., Ritchie, M. J., Simons, C. E., & Yano, E. M.
- Affiliations
- Central Arkansas Veterans Healthcare System (US)
- VA South Central Mental Illness Research, Education, and Clinical Center, North Little Rock, Arkansas, USA
- VA Puget Sound Health Care System (US)
- Health Services Research & Development (US)
- Quality Enhancement Research Initiative (US)
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2008-12-03
- Volume
- 19
- Issue
- 2
- Pages
- 229-242
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2171973830
- Cited by
- 71
- References
- 34
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 4 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 9 · 2014: 8 · 2013: 5 · 2012: 7
- FWCI
- 13.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Appreciative Inquiry and Organizational Change
- Keywords
- healthcare quality improvement, frontline workers, health managers, stakeholder preferences, knowledge sharing, organizational dialogue, workload, cost concerns, quality improvement implementation
- MeSH terms
- Communication, Delivery of Health Care, Hospitals, Veterans, Humans, Quality Assurance, Health Care, Qualitative Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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