New Issue Brief - Hospital Quality Improvement Activities: A Snapshot of the State of the Art

Five years after the IOM Report, relatively little is known about the depth and variety of current quality improvement (QI) efforts in hospitals, or about clinicians’ perceptions of QI activities and outcomes.  How do clinicians feel about the quality of care in their organizations, and how do these perceptions compare with external quality measures?  What kinds of processes correspond with greater performance gains?  How successful are current QI efforts?

Supported by a grant from the Commonwealth Fund to Boston University’s Health Policy Institute, HRET is collaborating with the Institute on a study of the current state of quality improvement (QI) activities in U.S. hospitals. Working with the study’s Principal Investigators, Alan B. Cohen and Joseph Restuccia, HRET will conduct two complementary surveys of the nation’s hospitals:

• Survey of Hospital Quality Improvement Activities—to collect information on QI initiatives currently underway in hospitals, and the resulting changes in structure and organization.  A sample of chief quality officers will be invited to submit data on quality goals, organizational culture, workforce strategies, and the use of information technology.
  
  
• Survey of Hospital Clinicians’ Perceptions of Quality—to gather data from front-line physicians and nurses on their perceptions of the quality of care in their organizations and the QI activities that have been undertaken there.

Survey findings will be combined with AHA data on hospital structural characteristics and with publicly available performance indicators from the surveyed hospitals.  The project will address four main research questions:

• What is the perceived quality of care in U.S. hospitals as assessed by clinicians?
  
  
• What structural and process characteristics are strongly associated with perceived quality of care?
  
  
• How do hospitals that differ in terms of perceived quality differ in terms of their QI activities and external performance measures?
  
  
• How do hospitals that differ in terms of perceived quality of care differ in terms of culture, strategy, and other structural and process characteristics?

Results will yield lessons for developing QI tools and educational resources and will establish process and structural benchmarks of hospitals currently engaged in QI. 

Funding: The Commonwealth Fund

Contact: Deborah Bohr, dbohr@aha.org