Developing a model for primary care quality improvement success: a comparative case study in rural, urban and Kaupapa Māori organisations.
Introduction. Primary care is under pressure to achieve accessible, equitable, quality health care, while being increasingly under resourced. There is a need to understand factors that influence quality improvement (QI) to support a high-performing primary care system. Literature highlights the impa...
| Publicado en: | Journal of Primary Health Care Vol. 15; no. 4; pp. 333 - 343 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
CSIRO Publishing
Dec2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174334019&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174334019 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11726164 92I9 jtl: Journal of Primary Health Care issn: 11726164 maglogo: N pubinfo: dt: Dec2023 vid: 15 iid: 4 pid: 1568 pub: CSIRO Publishing place: Canberra ACT, <Blank> artinfo: ui: 174334019 174334019 174334019 10.1071/HC23046 174334019 ppf: 333 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Developing a model for primary care quality improvement success: a comparative case study in rural, urban and Kaupapa Māori organisations. aug: au: Cullen, Jane Childerhouse, Paul Jayamaha, Nihal McBain, Lynn affil: Massey University, Palmerston North, New Zealand sug: subj: Primary Health Care Quality Improvement Maori Organizations Rural Areas Urban Areas Models, Theoretical Program Implementation Attitude of Health Personnel Evaluation Outcomes (Health Care) Human Case Studies Qualitative Studies Health Services Accessibility Implementation Science Semi-Structured Interview Teamwork Leadership Learning Environment Descriptive Statistics ab: Introduction. Primary care is under pressure to achieve accessible, equitable, quality health care, while being increasingly under resourced. There is a need to understand factors that influence quality improvement (QI) to support a high-performing primary care system. Literature highlights the impact of context on QI but there is little primary care research on this topic. Aim. This qualitative case study research seeks to discover the contextual factors influencing QI in primary care, and how the relationships between contextual factors, the QI initiative, and the implementation process influence outcomes. Methods. The Consolidated Framework for Implementation Research was used to frame this qualitative study exploring primary care experiences in depth. Six sites were selected to provide a sample of rural, urban and Kaupapa Māori settings. Qualitative data was collected via semi-structured interviews and compared and contrasted with the organisational documents and data provided by participants. Results. Cases reported success in achieving improved outcomes for patients, practices, and staff. Strong internal cultures of 'Clan' and 'Adhocracy' typologies supported teamwork, distributed leadership, and a learning climate to facilitate iterative sensemaking activities. To varying degrees, external network relationships provided resources, knowledge, and support. Discussion. Organisations were motivated by a combination of patient/community need and organisational culture. Network relationships assisted to varying degrees depending on need. Engaged and distributed leadership based on teamwork was observed, where leadership was shared and emerged at different levels and times as the need arose. A learning climate was supported to enable iterative sensemaking activities to achieve success. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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