Cincinnati Children's Hospital Medical Centre, 3333 Burnet Avenue, MLC 7009, Cincinnati, OH 45229, USA.
BMJ Qual Saf. 2012 Jan;21(1):13-20. doi: 10.1136/bmjqs-2011-000010. Epub 2011 Aug 10.
BACKGROUND Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen.
To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project.
10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model.
The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly.
The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.
质量改进（QI）工作在医疗保健领域已经广泛开展，但其成功率存在显著差异。人们认为，背景的差异是造成这种差异的部分原因。
为组织和 QI 研究人员开发一个概念模型，以理解和优化影响 QI 项目成功的背景因素。
10 名 QI 专家提供了系统文献综述的结果，然后参与了两轮意见收集，以确定和定义重要的背景因素。专家随后亲自会面，确定因素之间的关系，并开始构建模型。
理解质量成功模型（MUSIQ）是基于医疗保健系统的层次组织的，确定了 25 个可能影响 QI 成功的背景因素。微系统内的因素和与 QI 团队相关的因素被假设直接影响 QI 成功，而组织内和外部环境的因素则被认为间接影响成功。
MUSIQ 框架有可能指导医疗保健中 QI 方法的应用和研究重点。MUSIQ 的特异性和因素之间关系的明确划分允许更深入地了解背景影响 QI 成功的作用机制。MUSIQ 还为进一步的研究提供了基础，以测试和完善理论，推进 QI 科学领域的发展。
