Table 5 Contextual factors
From: The influence of contextual factors on healthcare quality improvement initiatives: a realist review
Domain | Factor | Description |
|---|---|---|
Leadership | Leadership | Supportive, active, engaged, effective, consistent, motivational, accessible, credible. Belief in QI. Blended leadership approach (top-down/bottom-up). |
Organisational characteristics | Organisational culture | Core values, attitudes, norms, systems, processes. Underlying ethos and principles. History. Implementation climate. Organisational commitment. |
Individual skills and capabilities | Individuals and groups/teams: QI expertise, understanding prior experience. Training, learning, development of a skill set to address ‘QI skills gap’. | |
Organisational capacity and capability | Improvement culture, prior initiatives, QI history and maturity. QI capacity. Developing or ongoing ‘organisational learning’. Availability of dedicated resources. | |
Data and technical infrastructure | Systems, measurement, monitoring, feedback: availability and use of data as a motivator to improve. Information systems in place to support systematic and standardised collection and use of data for improvement. Integration of data collection into existing practices to minimise ‘burden’ on staff. Technical capability of staff to use data. | |
Readiness for change | Receptiveness, shared resolve, belief, support, commitment, collective change efficacy. | |
Change agents | Championship | Change agents: driving and leading change. Ownership, engagement, participation. |
Multi-disciplinary collaboration | Relationships | Collaboration: multidisciplinary, formal/informal, external. Strong working relationships. Facilitation of communication across all levels. Support for networks. Consensus-building. |