Exploring the barriers and facilitators of continuous quality improvement for health promotion within healthcare food environments.

IF 2.3 4区 医学 Q2 HEALTH POLICY & SERVICES
Laura J Kennedy, Meaghan Sim, Jeanna Parsons Leigh, Sara F L Kirk, Catherine L Mah
{"title":"Exploring the barriers and facilitators of continuous quality improvement for health promotion within healthcare food environments.","authors":"Laura J Kennedy, Meaghan Sim, Jeanna Parsons Leigh, Sara F L Kirk, Catherine L Mah","doi":"10.1093/heapro/daaf020","DOIUrl":null,"url":null,"abstract":"<p><p>Continuous quality improvement (CQI) has become a widely accepted approach to optimize health services while lowering healthcare costs (Quintuple Aim) and has expanded from clinical interventions to health promotion. Retail food environments (e.g. hospital cafeterias, cafes) are of interest given the increased adoption of healthy eating policies and interventions to influence diet (e.g. price, promotion, placement and product). However, there is a lack of understanding of what organizational and policy processes are necessary to implement CQI for health promotion in healthcare. This research uses a qualitative multiple exploratory case study design to explore the barriers and facilitators of CQI for health promotion in healthcare retail food environments. This research occurred in a healthcare setting with an organizational Healthy Eating Policy applicable to staff, patients and visitors. We collected semi-structured interview data with 12 healthcare staff working in Nutrition & Food Services in a Canadian provincial health authority from January to June 2023. We used directed content analysis to analyze the data. We used the Inside out model to interpret cross-cutting organizational barriers and facilitators. Four cases of quality improvement interventions (Plan-Do-Study-Act (PDSA) cycles) were identified. Barriers included expertise to interpret nutrient criteria, lack of data, conflicting benchmarks (e.g. finance and health), third-party vendors, past negative experiences, and a lack of time to monitor and evaluate. Facilitators included an organizational Healthy Eating Policy, understanding community context, local knowledge, partnerships with researchers and leadership. This study revealed how overarching policies, accompanied by organizational support, facilitated quality improvement and engagement in CQI but also created barriers to routine practice and sustainability of health-promoting interventions.</p>","PeriodicalId":54256,"journal":{"name":"Health Promotion International","volume":"40 2","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965982/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Promotion International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/heapro/daaf020","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Continuous quality improvement (CQI) has become a widely accepted approach to optimize health services while lowering healthcare costs (Quintuple Aim) and has expanded from clinical interventions to health promotion. Retail food environments (e.g. hospital cafeterias, cafes) are of interest given the increased adoption of healthy eating policies and interventions to influence diet (e.g. price, promotion, placement and product). However, there is a lack of understanding of what organizational and policy processes are necessary to implement CQI for health promotion in healthcare. This research uses a qualitative multiple exploratory case study design to explore the barriers and facilitators of CQI for health promotion in healthcare retail food environments. This research occurred in a healthcare setting with an organizational Healthy Eating Policy applicable to staff, patients and visitors. We collected semi-structured interview data with 12 healthcare staff working in Nutrition & Food Services in a Canadian provincial health authority from January to June 2023. We used directed content analysis to analyze the data. We used the Inside out model to interpret cross-cutting organizational barriers and facilitators. Four cases of quality improvement interventions (Plan-Do-Study-Act (PDSA) cycles) were identified. Barriers included expertise to interpret nutrient criteria, lack of data, conflicting benchmarks (e.g. finance and health), third-party vendors, past negative experiences, and a lack of time to monitor and evaluate. Facilitators included an organizational Healthy Eating Policy, understanding community context, local knowledge, partnerships with researchers and leadership. This study revealed how overarching policies, accompanied by organizational support, facilitated quality improvement and engagement in CQI but also created barriers to routine practice and sustainability of health-promoting interventions.

求助全文
约1分钟内获得全文 求助全文
来源期刊
Health Promotion International
Health Promotion International Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.70
自引率
7.40%
发文量
146
期刊介绍: Health Promotion International contains refereed original articles, reviews, and debate articles on major themes and innovations in the health promotion field. In line with the remits of the series of global conferences on health promotion the journal expressly invites contributions from sectors beyond health. These may include education, employment, government, the media, industry, environmental agencies, and community networks. As the thought journal of the international health promotion movement we seek in particular theoretical, methodological and activist advances to the field. Thus, the journal provides a unique focal point for articles of high quality that describe not only theories and concepts, research projects and policy formulation, but also planned and spontaneous activities, organizational change, as well as social and environmental development.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信