What Do Collaborative Improvement Projects Do? Experience from Seven Countries

Tim Wilson M.D. (Director), Donald M. Berwick M.D., M.P.P. (CEO and President), Paul D. Cleary Ph.D. (Professor)
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引用次数: 0

Abstract

Background

Health care organizations are increasingly adopting multiorganizational collaborative approaches to quality improvement. Collaboratives have been conducted in many countries. There are large variations in the way collaboratives are structured and run, but there is no widely accepted framework for describing the components of collaboratives. Thus, it is difficult to study which approaches are most effective.

Method

The authors conducted semistructured interviews with 15 leaders of collaboratives to ascertain the common components of collaboratives and identify variations in the ways these components are implemented.

Results

The study identified seven features of collaboratives that the leaders interviewed thought were critical determinants of how effective the collaboratives were: sponsorship, topic, ideas for improvements, participants, senior leadership support, preliminary work and learning, and strategies for learning about and making improvements. For example, every interviewee mentioned that having participants collect data, perform audit work, or analyze the system they were in before the collaboration started was important to understanding their organization and the nature of the problems they had and to developing baseline data for later comparison. The authors describe variations in how these features have been implemented and possible functions of these features.

Conclusion

Systematically studying the impact of variations in the seven key features of collaboratives could yield important information about their role and impact.

协作改进项目做什么?七个国家的经验
卫生保健组织越来越多地采用多组织协作的方法来提高质量。在许多国家开展了合作。协作的结构和运行方式有很大的变化,但是没有一个被广泛接受的框架来描述协作的组件。因此,很难研究哪种方法最有效。方法作者对15位合作组织领导人进行了半结构化访谈,以确定合作组织的共同组成部分,并确定这些组成部分在实施方式上的差异。研究确定了协作的七个特征,受访领导人认为这些特征是协作效果的关键决定因素:赞助、主题、改进的想法、参与者、高层领导的支持、初步工作和学习,以及学习和改进的策略。例如,每个受访者都提到,让参与者收集数据,执行审计工作,或者在协作开始之前分析他们所在的系统,这对于了解他们的组织和他们所面临的问题的性质,以及为以后的比较开发基线数据非常重要。作者描述了如何实现这些特性的变化以及这些特性的可能功能。结论系统地研究协作者七个关键特征变化的影响,可以提供有关其作用和影响的重要信息。
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