ISQua's 39th International Conference 2023

What Does It Take to Sustain the Gains From Hospital-wide Quality Initiatives? Evidence From a Systematic Review

Introduction

More comprehensive theoretical and practical understandings are required to achieve sustained improvement from hospital-wide quality and safety initiatives, and to sustainably benefit the safety and quality of hospital care.

Aim

To identify enabling and hindering factors and their contributions to improvement sustainability from hospital-wide change to enhance patient safety and quality.

Method

•Systematic scoping review

•Grey and peer-reviewed records (searched: PubMed, Scopus, World of Science®, CINAHL, Health Business Elite, Health Policy Reference Centre and Cochrane Library)

•Review inclusion criteria: 1) publication between 2010 and Nov 2020 in 2) English, study conducted 3) in the western Organisation for Economic Co-operation and Development countries, 4) after the active implementation, in 5) hospital setting(s), on 6) hospital-wide initiatives, provided 7) empirical factors for sustained improvement

Results

•21,956 search returns à 17 records (peer reviewed) included in the review

•Studies conducted 4.3 years on average after initiative completion

•62 enabling and hindering factors to sustained improvement – three overarching themes: People, Process and Organisational Environment

•59% records reported the implementation of evidence based practice

•53% records drew on improvement science

People: Actors and their roles in change

Process: Planning, execution and maintenance of change

Organisational Environment: Internal contexts that enabled/constrained sustained improvement

Conclusions

The findings provide contemporary empirical factors for, and the mechanisms of improvement sustainability of hospital-wide quality initiatives to improve patient safety and quality. These extend theoretical and empirical knowledge for achieving the sustainability of large-scale change outcomes.

ISQua's 39th International Conference 2023

WHAT DOES IT TAKE TO SUSTAIN THE GAINS FROM HOSPITAL-WIDE QUALITY INITIATIVES? EVIDENCE FROM A SYSTEMATIC REVIEW.

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