The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement

Kaplan, Heather C.; Provost, Lloyd; Froehle, Craig M.; Margolis, Peter A.

doi:10.1136/bmjqs-2011-000010

Cited by 461 publications

(466 citation statements)

References 38 publications

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“…Ten years later, observers are still asking why health care quality has largely not improved, 34 and attempting to develop frameworks to help guide improvement. 42 …”

Section: Quality Improvementmentioning

confidence: 99%

Assessing Quality Improvement in Health Care: Theory for Practice

Kleinman

Dougherty

2013

Pediatrics

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To review the role of theory as a means to enhance the practice of quality improvement (QI) research and to propose a novel conceptual model focused on the operations of health care. METHODS:Conceptual model, informed by literature review. RESULTS:To optimize learning across QI studies requires the integration of small-scale theories (middle-range theories, theories of change) within the context of larger unifying theories. We propose that health care QI research would benefit from a theory that describes the operations of health care delivery, including the multiplicity of roles that interpersonal interactions play. The broadest constructs of the model are entry into the system, and assessment and management of the patient, with the subordinate operations of access; recognition, assessment, and diagnosis; and medical decision-making (developing a plan), coordination of care, execution of care, referral and reassessment, respectively. Interpersonal aspects of care recognize the patient/ caregiver as a source of information, an individual in a cultural context, a complex human being, and a partner in their care. Impacts to any and all of these roles may impact the quality of care.CONCLUSIONS: Such a theory can promote opportunities for moving the field forward and organizing the planning and interpretation of comparable studies. The articulation of such a theory may simultaneously provide guidance for the QI researcher and an opportunity for refinement and improvement. Pediatrics 2013;131:S110-S119

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“…Ten years later, observers are still asking why health care quality has largely not improved, 34 and attempting to develop frameworks to help guide improvement. 42 …”

Section: Quality Improvementmentioning

confidence: 99%

Assessing Quality Improvement in Health Care: Theory for Practice

Kleinman

Dougherty

2013

Pediatrics

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“…Improvement Science also adds theoretical frameworks for the implementation of healthcare quality improvement interventions, although it acknowledges their inherent limitations, due both to simplification and non-exhaustiveness, which impacts their applicability 61,62,70 . Such theoretical frameworks feature Promoting Action on Research Implementation in Health Services (PARI-HS), the Consolidated Framework for Implementation Research (CFIR), the Theoretical Domains Framework (TDF), and the Model for Understanding Success in Quality (MUSIQ) ( Table 2).…”

Section: Theoretical Basis For the Design Implementation And Evaluamentioning

confidence: 99%

“…MUSIQ 66,70 addresses contextual variables classified according to the level of the system in which they operate: microsystems, consisting of small groups that work directly in healthcare provision; macrosystems, which include various microsystems or organizations; and the outer setting, involving characteristics of the society in which the macrosystems act. It is assumed that factors pertaining to microsystems and healthcare quality improvement teams have a direct influence, while organizational factors and the outer setting indirectly influence the intervention's success.…”

Section: Theoretical Basis For the Design Implementation And Evaluamentioning

confidence: 99%

Improvement Science: conceptual and theoretical foundations for its application to healthcare quality improvement

et al. 2016

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The development and study of healthcare quality improvement interventions have been reshaped, moving from more intuitive approaches, dominated by biomedical vision and premised on easy transferability, to gradually acknowledge the need for more planning and systematization, with greater incorporation of the social sciences and enhancement of the role of context. Improvement Science has been established, with a conceptual and methodological framework for such studies. Considering the incipient of the debate and scientific production on Improvement Science in Brazil, this article aims to expound its principal conceptual and theoretical fundamentals, focusing on three central themes: the linkage of different disciplines; recognition of the role of context; and the theoretical basis for the design, implementation, and evaluation of interventions.

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“…The Model for Understanding Success in Quality, MUSIQ [24], highlights the importance of motivation due to leadership. Other significant factors for improvement work are the values and norms of the care teams, that is, how they develop, relate to, and communicate with patients and each other.…”

Section: Introductionmentioning

confidence: 99%

“…Staff's motivation for learning is imperative to continuous improvements in patient care [5,16,[21][22][23][24]. The Model for Understanding Success in Quality, MUSIQ [24], highlights the importance of motivation due to leadership.…”

Section: Introductionmentioning

confidence: 99%

Using Numbers Creates Value for Health Professionals: A Quantitative Study of Pain Management in Palliative Care

Unné

Rosengren

2014

Pharmacy

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Improvement methodology is based on processes to achieve quality and safety in health care in order to improve patient care, especially in management. The aim of this study was to identify differences regarding the method of estimating pain within palliative care in north-eastern Sweden. The study comprised three different data collections-questions from 22 staff members who worked in palliative care, data from the Swedish Palliative Registry, and patients' medical records. Data were analyzed using a quantitative approach to measure the proportion of differences and similarities in everyday pain management. The two categories "Documentation of Pain Management" and "Pain Management Activities" were identified and illustrated how repeated pain management measurements contributed to a clearer view of pain management activities. The use of numbers instead of words contributed to a better, clearer, and more unified documentation of pain ratings. Use of validated rating tools regarding patients last week of life increased from 47%-100%. This study may inspire better routines to estimate pain and quantify no pain in palliative care. Evidence-based measurement tools from the patient's perspective, can improve pain management.

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The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement

Cited by 461 publications

References 38 publications

Assessing Quality Improvement in Health Care: Theory for Practice

Assessing Quality Improvement in Health Care: Theory for Practice

Improvement Science: conceptual and theoretical foundations for its application to healthcare quality improvement

Using Numbers Creates Value for Health Professionals: A Quantitative Study of Pain Management in Palliative Care

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