Department of Surgery and Cancer, Imperial College London, London, UK.
BMJ Open. 2013 Jan 3;3(1):e001731. doi: 10.1136/bmjopen-2012-001731.
To identify the critical dimensions of hospital Chief Executive Officers' (CEOs) involvement in a quality and safety and to offer practical guidance to assist CEOs to fulfil their leadership role in quality improvement (QI).
Qualitative interview study.
20 organisations participating in the main phase of the Safer Patients Initiative (SPI) programme across the UK.
17 CEOs overseeing 19 organisations participating in the main phase of the SPI programme and 36 staff (20 workstream leads, 10 coordinators and 6 managers) involved in SPI across all 20 participating organisations.
Self-reported perceptions of CEOs on their contribution and involvement within the SPI programme, supplemented by staff peer-reports.
The CEOs recognised the importance of their part in the SPI programme and gave detailed accounts of the perceived value that their involvement had brought at all stages of the process. In exploring the parts played by the CEOs, five dimensions were identified: (1) resource provision; (2) staff motivation and engagement; (3) commitment and support; (4) monitoring progress and (5) embedding programme elements. Staff reports confirmed these dimensions; however, the weighting of the dimensions differed. The findings stress the importance of particular actions of support and monitoring such as constant communication through leadership walk rounds and reviewing programme progress and its related clinical outcomes at Board meetings.
This study addressed the call for more research-informed practical guidance on the role of senior management in QI s. The findings show that the CEOs provided key participation considered to significantly contribute towards the SPI programme. CEOs and staff identified a number of clear and consistent themes essential to organisation safety improvement. Queries raised include the tangible benefits of executive involvement in changing structures and embedding for sustainability and the practical steps to creating the 'right' environment for QI.
确定医院首席执行官（CEO）参与质量和安全的关键维度，并提供实用指导，以帮助 CEO 发挥其在质量改进（QI）方面的领导作用。
定性访谈研究。
英国 20 个参与 Safer Patients Initiative（SPI）计划主要阶段的组织。
17 名监督参与 SPI 计划主要阶段的 19 个组织的 CEO 以及 36 名员工（20 名工作流负责人、10 名协调员和 6 名经理），他们在所有 20 个参与组织中都参与了 SPI。
CEO 对其在 SPI 计划中的贡献和参与的自我报告认知，辅以员工同行报告。
CEO 们认识到他们在 SPI 计划中的重要作用，并详细描述了他们参与各个阶段所带来的感知价值。在探索 CEO 所扮演的角色时，确定了五个维度：（1）资源提供；（2）员工激励和参与；（3）承诺和支持；（4）监测进展；（5）嵌入计划要素。员工报告证实了这些维度；然而，维度的权重不同。研究结果强调了支持和监测等特定行动的重要性，例如通过领导巡视进行持续沟通，以及在董事会会议上审查计划进展及其相关临床结果。
本研究回应了关于高级管理层在 QI 中的作用的更多基于研究的实用指导的呼吁。研究结果表明，CEO 提供了被认为对 SPI 计划有重大贡献的关键参与。CEO 和员工确定了一些明确和一致的主题，这些主题对组织安全改进至关重要。提出的问题包括高管参与改变结构和为可持续性嵌入的实际收益，以及为 QI 创建“正确”环境的实际步骤。
