A Sustainability Oriented and Mentored Approach to Implementing a Fall Prevention Guideline in Acute Care Over 2 Years

Ploeg, Jenny; Ireland, Sandra; Cziraki, Karen; Northwood, Melissa; Zečević, Aleksandra; Davies, Barbara; Murray, Mary; Higuchi, Kathryn Smith

doi:10.1177/2377960818775433

“…The NIATx200 initiative utilized the British National Health Services Sustainability Index (BNHS-SI) to assess staff perceptions about the likelihood that a change will be sustained in the organization [23,24]. The BNHS-SI has been utilized across multiple healthcare settings to assess staff perceptions about the sustainability of an organizational change [24,[35][36][37][38][39][40][41][42][43][44][45] and as a qualitative framework to qualitatively identify factors associated with the concept of sustainability [44,[46][47][48].…”

Section: Outcomes and Measurementmentioning

confidence: 99%

Influence of participation in a quality improvement collaborative on staff perceptions of organizational sustainability

Ford

¹

,

Gilson

²

2021

BMC Health Serv Res

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Background Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200). Methods A mixed linear model repeated measures analysis was applied to matched staff members (n = 908, representing 2329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III). Results For Model I, staff perceptions of total SC increased throughout most of the study (t1,4 = − 6.74, p < .0001; t2,4 = − 3.100, p < .036; t3,4 = − 0.23, p = ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t = − 2.23, p = .026), staff job function (t = − 3.27, p = .001), and organizational administrators (t = − 3.50, p = .001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t = − 3.09, p < .002) and being in a free-standing clinic (t = − 2.06, p < .04) on staff perceptions of total SC. Conclusion Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change. Trial registration ClinicalTrials.gov, NCT00934141. Registered July 6, 2009. Retrospectively registered.

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“…The NIATx200 initiative utilized the British National Health Services Sustainability Index (BNHS-SI) to assess staff perceptions about the likelihood that a change will be sustained in the organization [23,24]. The BNHS-SI has been utilized across multiple healthcare settings to assess staff perceptions about the sustainability of an organizational change [24,[33][34][35][36][37][38][39][40][41][42][43] and as a qualitative framework to qualitatively identify factors associated with the concept of sustainability [42,[44][45][46].…”

Section: Outcome Measuresmentioning

confidence: 99%

Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability

Ford

¹

,

Gilson

²

2020

Preprint

0

View full text Add to dashboard Cite

Background: Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200).Methods: A mixed linear model repeated measures analysis was applied to matched staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III).Results: For Model I, staff perceptions of total SC increased throughout most of the study (t1,4=-6.74, p<.0001; t2,4=-3.100, p<.036; t3,4=-0.23, p=ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t=-2.23, p=.026), staff job function (t=-3.27, p=.001), and organizational administrators (t=-3.50, p=.001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t=-3.09, p<.002) and being in a free-standing clinic (t=-2.06, p<.04) on staff perceptions of total SC. Conclusion: Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141

show abstract

“…The NIATx200 initiative utilized the British National Health Services Sustainability Index (BNHS-SI) to assess staff perceptions about the likelihood that a change will be sustained in the organization [23,24]. The BNHS-SI has been utilized across multiple healthcare settings to assess staff perceptions about the sustainability of an organizational change [24,[34][35][36][37][38][39][40][41][42][43][44] and as a qualitative framework to qualitatively identify factors associated with the concept of sustainability [43,[45][46][47].…”

Section: Outcomes and Measurementmentioning

confidence: 99%

Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability

Ford

¹

,

Gilson

²

2020

Preprint

0

View full text Add to dashboard Cite

Background: Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200).Methods: A mixed linear model repeated measures analysis was applied to matched staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III).Results: For Model I, staff perceptions of total SC increased throughout most of the study (t1,4=-6.74, p<.0001; t2,4=-3.100, p<.036; t3,4=-0.23, p=ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t=-2.23, p=.026), staff job function (t=-3.27, p=.001), and organizational administrators (t=-3.50, p=.001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t=-3.09, p<.002) and being in a free-standing clinic (t=-2.06, p<.04) on staff perceptions of total SC. Conclusion: Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141

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A Sustainability Oriented and Mentored Approach to Implementing a Fall Prevention Guideline in Acute Care Over 2 Years

Cited by 9 publications

References 31 publications

Influence of participation in a quality improvement collaborative on staff perceptions of organizational sustainability

Influence of participation in a quality improvement collaborative on staff perceptions of organizational sustainability

Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability

Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability

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