A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact
Abstract Background The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-024-10828-0 |
| _version_ | 1797199534856601600 |
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| author | Aklilu Endalamaw Resham B Khatri Tesfaye Setegn Mengistu Daniel Erku Eskinder Wolka Anteneh Zewdie Yibeltal Assefa |
| author_facet | Aklilu Endalamaw Resham B Khatri Tesfaye Setegn Mengistu Daniel Erku Eskinder Wolka Anteneh Zewdie Yibeltal Assefa |
| author_sort | Aklilu Endalamaw |
| collection | DOAJ |
| description | Abstract Background The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts. Methods This qualitative scoping review was conducted using Arksey and O’Malley’s methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works. Results A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI. Conclusions Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it’s crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care. |
| first_indexed | 2024-04-24T07:17:17Z |
| format | Article |
| id | doaj.art-44d99ee3bfa2466d97e5af06719ddbd2 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-24T07:17:17Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-44d99ee3bfa2466d97e5af06719ddbd22024-04-21T11:13:13ZengBMCBMC Health Services Research1472-69632024-04-0124111410.1186/s12913-024-10828-0A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impactAklilu Endalamaw0Resham B Khatri1Tesfaye Setegn Mengistu2Daniel Erku3Eskinder Wolka4Anteneh Zewdie5Yibeltal Assefa6School of Public Health, The University of QueenslandSchool of Public Health, The University of QueenslandSchool of Public Health, The University of QueenslandSchool of Public Health, The University of QueenslandInternational Institute for Primary Health Care in EthiopiaInternational Institute for Primary Health Care in EthiopiaSchool of Public Health, The University of QueenslandAbstract Background The growing adoption of continuous quality improvement (CQI) initiatives in healthcare has generated a surge in research interest to gain a deeper understanding of CQI. However, comprehensive evidence regarding the diverse facets of CQI in healthcare has been limited. Our review sought to comprehensively grasp the conceptualization and principles of CQI, explore existing models and tools, analyze barriers and facilitators, and investigate its overall impacts. Methods This qualitative scoping review was conducted using Arksey and O’Malley’s methodological framework. We searched articles in PubMed, Web of Science, Scopus, and EMBASE databases. In addition, we accessed articles from Google Scholar. We used mixed-method analysis, including qualitative content analysis and quantitative descriptive for quantitative findings to summarize findings and PRISMA extension for scoping reviews (PRISMA-ScR) framework to report the overall works. Results A total of 87 articles, which covered 14 CQI models, were included in the review. While 19 tools were used for CQI models and initiatives, Plan-Do-Study/Check-Act cycle was the commonly employed model to understand the CQI implementation process. The main reported purposes of using CQI, as its positive impact, are to improve the structure of the health system (e.g., leadership, health workforce, health technology use, supplies, and costs), enhance healthcare delivery processes and outputs (e.g., care coordination and linkages, satisfaction, accessibility, continuity of care, safety, and efficiency), and improve treatment outcome (reduce morbidity and mortality). The implementation of CQI is not without challenges. There are cultural (i.e., resistance/reluctance to quality-focused culture and fear of blame or punishment), technical, structural (related to organizational structure, processes, and systems), and strategic (inadequate planning and inappropriate goals) related barriers that were commonly reported during the implementation of CQI. Conclusions Implementing CQI initiatives necessitates thoroughly comprehending key principles such as teamwork and timeline. To effectively address challenges, it’s crucial to identify obstacles and implement optimal interventions proactively. Healthcare professionals and leaders need to be mentally equipped and cognizant of the significant role CQI initiatives play in achieving purposes for quality of care.https://doi.org/10.1186/s12913-024-10828-0Continuous quality improvementQuality of Care |
| spellingShingle | Aklilu Endalamaw Resham B Khatri Tesfaye Setegn Mengistu Daniel Erku Eskinder Wolka Anteneh Zewdie Yibeltal Assefa A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact BMC Health Services Research Continuous quality improvement Quality of Care |
| title | A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact |
| title_full | A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact |
| title_fullStr | A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact |
| title_full_unstemmed | A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact |
| title_short | A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact |
| title_sort | scoping review of continuous quality improvement in healthcare system conceptualization models and tools barriers and facilitators and impact |
| topic | Continuous quality improvement Quality of Care |
| url | https://doi.org/10.1186/s12913-024-10828-0 |
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