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Cited by 382Healthcare Quality and ManagementHealth Policy Implementation SciencePsychiatric care and mental health services

Factors associated with the impact of quality improvement collaboratives in mental healthcare: An exploratory study

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Versteeg, Marleen H, Laurant, Miranda GH, Franx, Gerdien C, Jacobs, Annelies J, Wensing, Michel JP·2012·Implementation Science
DOI 10.1186/1748-5908-7-1PMC PMC3313876
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Abstract

Background: Quality improvement collaboratives (QICs) bring together groups of healthcare professionals to work in a structured manner to improve the quality of healthcare delivery within particular domains. We explored which characteristics of the composition, participation, functioning, and organization of these collaboratives related to changes in the healthcare for patients with anxiety disorders, dual diagnosis, or schizophrenia. Methods: We studied three QICs involving 29 quality improvement (QI) teams representing a number of mental healthcare organizations in the Netherlands. The aims of the three QICs were the implementation of multidisciplinary practice guidelines in the domains of anxiety disorders, dual diagnosis, and schizophrenia, respectively. We used eight performance indicators to assess the impact of the QI teams on self-reported patient outcomes and process of care outcomes for 1,346 patients. The QI team members completed a questionnaire on the characteristics of the composition, participation in a national program, functioning, and organizational context for their teams. It was expected that an association would be found between these team characteristics and the quality of care for patients with anxiety disorders, dual diagnosis, and schizophrenia. Results: No consistent patterns of association emerged. Theory-based factors did not perform better than practice-based factors. However, QI teams that received support from their management and both active and inspirational team leadership showed better results. Rather surprisingly, a lower average level of education among the team members was associated with better results, although less consistently than the management and leadership characteristics. Team views with regard to the QI goals of the team and attitudes towards multidisciplinary practice guidelines did not correlate with team success. Conclusions: No general conclusions about the impact of the characteristics of QI teams on the quality of healthcare can be drawn, but support of the management and active, inspirational team leadership appear to be important. Not only patient outcomes but also the performance indicators of monitoring and screening/assessment showed improvement in many but not all of the QI teams with such characteristics. More studies are needed to identify factors associated with the impact of multidisciplinary practice guidelines in mental healthcare.

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  • Most sustainability research focuses on categorizing factors presumably associated with program continuation.

    “As was documented in a systematic review of 125 empirical studies of health-focused interventions, most sustainability research focuses on categorizing factors presumably associated with program continuation—known as program sustainment [15].”

    From Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention (2022) · cites this paper as [15]

    The Methods (Data analysis) and Results (Associations between QI team factors and performance indicators) examine factors associated with the impact of mental-healthcare quality-improvement teams. Searches for a systematic review of 125 studies, sustainability, and program continuation found no passage in our copy addressing the attributed claim. (LLM, conf=0.77)

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  • Despite an increase in the number of studies focusing on program sustainment, there remains a relative dearth of empirical evidence on the combinations of factors associated with sustainment, especially those guided by established sustainment frameworks and measurement tools.

    “Despite an increase in the number of studies focusing on program sustainment, there remains a relative dearth of empirical evidence on the combinations of factors associated with sustainment [15, 16, 59], especially those guided by established sustainment frameworks and measurement tools [23].”

    From Using qualitative comparative analysis to uncover multiple pathways to program sustainment: implications for community-based youth substance misuse prevention (2022) · cites this paper as [15]

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Authors
Versteeg, M. H., Laurant, M. G., Franx, G. C., Jacobs, A. J., & Wensing, M. J.
Affiliations
  • Radboud University Medical Center (NL)
  • Trimbos Institute (NL)
Corresponding author
Laurant, Miranda GH
ORCID
Venue
Implementation Science
Publisher
Springer Science and Business Media LLC
Published
2012-01-09
Volume
7
Issue
1
Pages
1-1
ISSN
1748-5908 (ISSN-L)
DOI
10.1186/1748-5908-7-1
PMC
PMC3313876
OpenAlex
W2116775351
Cited by
382
References
24
Citations by year
2026: 2 · 2025: 4 · 2024: 6 · 2023: 9 · 2022: 31 · 2021: 74 · 2020: 25 · 2019: 31 · 2018: 42 · 2017: 47 · 2016: 42 · 2015: 30 · 2014: 15 · 2013: 22 · 2012: 2
FWCI
35.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Implementation Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
Funders
  • ZonMw
  • Trimbos-instituut
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 › Psychology › Clinical Psychology › Psychiatric care and mental health services
Keywords
quality improvement collaborative, mental health services, anxiety disorders, dual diagnosis, schizophrenia, management support, team leadership, patient outcomes, process of care, screening evaluation, guideline implementation
MeSH terms
Anxiety Disorders, Clinical Competence, Cooperative Behavior, Humans, Interprofessional Relations, Mental Health Services, National Health Programs, Netherlands, Patient Care Team, Surveys and Questionnaires, Schizophrenia, Program Evaluation, Outcome Assessment, Health Care, Practice Guidelines as Topic, Efficiency, Organizational, Quality Indicators, Health Care, Quality Improvement

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