What do collaborative improvement projects do? Experience from seven countries.

Abstract

BACKGROUND: Health care organizations are increasingly adopting multiorganizational collaborative approaches to quality improvement. Collaboratives have been conducted in many countries. There are large variations in the way collaboratives are structured and run, but there is no widely accepted framework for describing the components of collaboratives. Thus, it is difficult to study which approaches are most effective. METHOD: The authors conducted semistructured interviews with 15 leaders of collaboratives to ascertain the common components of collaboratives and identify variations in the ways these components are implemented. RESULTS: The study identified seven features of collaboratives that the leaders interviewed thought were critical determinants of how effective the collaboratives were: sponsorship, topic, ideas for improvements, participants, senior leadership support, preliminary work and learning, and strategies for learning about and making improvements. For example, every interviewee mentioned that having participants collect data, perform audit work, or analyze the system they were in before the collaboration started was important to understanding their organization and the nature of the problems they had and to developing baseline data for later comparison. The authors describe variations in how these features have been implemented and possible functions of these features. CONCLUSION: Systematically studying the impact of variations in the seven key features of collaboratives could yield important information about their role and impact.