Sustainable process improvements: Evidence from intervention‐based research

Abstract

This research develops a methodology for making process improvements that can sustain over time. Working with caregivers at a large U.S. hospital over 3 years, we redesign a process for educating kidney transplant patients with instructions for post‐surgical care. Adopting an intervention‐based research (IBR) framework and based on our actions to overcome challenges in implementation and sustainment of the redesign, we revise the current understanding of organizational learning theory. Follow‐up observations after our intervention show that the process improvements at the hospital are sustained. We supplement the IBR with quantitative analyses and provide evidence of improvements in health outcomes and satisfaction levels of patients associated with the redesign. These analyses are based on difference‐in‐difference estimations using data from transplant patients, including a control group from other transplant units. Overall, our research specifies a methodology for implementing sustainable process improvements, particularly in high interaction service environments such as healthcare delivery, and identifies refinements to organizational learning theory, especially for such environments.

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“…Utilizing the IBR approach involved working closely with the frontline nurses and physicians and holding focused-group discussions with recent transplant patients in our target hospital. While applying health care delivery and service operations theory to address the complexities of transition of care for kidney transplant patients, we faced several constraints and discovered gaps in the service delivery and transition of care arguments (e.g., Anand et al, 2021;Donabedian, 1988;Senot, 2019) that justified modifications based on the evidence from practice. This resulted in the design of our intervention of a standardized peer mentoring program wherein former transplant recipients are taught about discharge instructions and serve as mentors to current transplant recipients.…”