Mental Health Quality Enhancement Research Initiative, North Little Rock, AR 72114, USA.
J Eval Clin Pract. 2012 Feb;18(1):63-9. doi: 10.1111/j.1365-2753.2010.01518.x. Epub 2010 Aug 24.
Translating promising research findings into routine clinical care has proven difficult to achieve; even highly efficacious programmes remain unadopted. Critical to changing care is an understanding of the context within which the improvement effort occurs, including the climate or culture. Health care systems are multicultural due to the wide variety of professionals, subgroups, divisions and teams within them. Yet, little work describes and compares different stakeholders' views on their and others' roles in promoting successful quality improvement implementation.
To identify manager and frontline staff perspectives about which organizational stakeholders should play a role in implementation efforts as well as what implementation roles these stakeholders should perform.
We conducted qualitative semi-structured interviews of a purposive sample of stakeholders at the clinic, medical centre and regional network levels. Participants included stakeholders across five clinics (n = 49), their four affiliated medical centres (n = 12) and three regional networks (n = 7). Working in coding teams, we conducted a content analysis utilizing Atlas.ti Version 5.
According to informants, individuals at each organizational level have unique and critical roles to play in implementing and sustaining quality improvement efforts. Informants advocated for participation of a wide range of organizational members, described distinct roles for each group, and articulated the need for and defined the characteristics of frontline programme champions.
Involvement of multiple types of stakeholders is likely to be costly for health care organizations. Yet, if such organizations are to achieve the highest quality care, it is also likely that such involvement is essential.
将有前途的研究成果转化为常规临床护理已被证明难以实现；即使是高效的方案仍未被采用。改变护理的关键是了解改进工作发生的背景，包括环境或文化。由于专业人员、子群体、部门和团队的多样性，医疗保健系统是多元文化的。然而，很少有工作描述和比较不同利益相关者对其和其他人在促进成功质量改进实施方面的角色的看法。
确定经理和一线员工对哪些组织利益相关者应该在实施工作中发挥作用以及这些利益相关者应该扮演哪些实施角色的看法。
我们对诊所、医疗中心和区域网络各级的利益相关者进行了有针对性的定性半结构化访谈。参与者包括五个诊所（n = 49）、四个附属医疗中心（n = 12）和三个区域网络（n = 7）的利益相关者。我们在编码团队中使用 Atlas.ti Version 5 进行内容分析。
根据线人，每个组织层面的个人都有独特和关键的角色来实施和维持质量改进工作。线人倡导广泛的组织成员参与，为每个群体描述了不同的角色，并阐述了对一线计划冠军的需求和定义了其特征。
涉及多种类型的利益相关者对于医疗保健组织来说可能成本高昂。然而，如果这些组织要实现最高质量的护理，那么这种参与也很可能是必要的。
