Improving improvement.
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Delivery of Health Care↗
Biomedical subjects
Bruce D Agins
Publications and source records attributed to Bruce D Agins.
Self-management of chronic disease.
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Chronic Disease↗
Editorial comment: does this drug make the patient better or worse? Interactions between pharmacists and members of the health care team.
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Antiretroviral Therapy, Highly Active↗
Factors associated with the successful implementation of a quality improvement project in human immunodeficiency virus ambulatory care clinics.
We examined a quality improvement (QI) program, offered to ambulatory care clinics (N = 82) serving human immunodeficiency virus-positive clients, to determine what factors predicted the clinic independently implementing QI processes without their program consultant's help. Initial analyses examined clinics at 4 levels of involvement: withdrew from the project, initial QI proficiency, advanced QI proficiency, and consultant independent. The initial and advanced stages were collapsed into 1 group (consultant dependent) and compared with consultant-independent clinics for multivariate logistic regression. In the multivariate models, 3 factors significantly predicted the clinic being consultant independent: staffing level (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.2-2.2), the number of participating months (OR = 1.4, 95% CI = 1.0-2.0), and baseline QI readiness (OR = 1.1, 95% CI = 1.0-1.3). Receiver operator curves were calculated for significant predictors; the strongest predictor was staffing (c statistic = .79). Clinics that are organizationally prepared for QI, allow adequate time to adopt QI methods into their organization, and provide adequate QI staffing are more likely to independently apply QI methods.
Ambulatory Care Facilities↗