Decision-maker roles in healthcare quality improvement projects: a scoping review
Objectives Evidence suggests that healthcare quality improvement (QI) projects are more successful when decision-makers are involved in the process. However, guidance regarding the engagement of decision-makers in QI projects is lacking. We conducted a scoping review to identify QI projects involvin...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-03-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/13/1/e002522.full |
| _version_ | 1827168281325207552 |
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| author | Isabelle Gaboury Justin Gagnon Mylaine Breton |
| author_facet | Isabelle Gaboury Justin Gagnon Mylaine Breton |
| author_sort | Isabelle Gaboury |
| collection | DOAJ |
| description | Objectives Evidence suggests that healthcare quality improvement (QI) projects are more successful when decision-makers are involved in the process. However, guidance regarding the engagement of decision-makers in QI projects is lacking. We conducted a scoping review to identify QI projects involving decision-makers published in the literature and to describe the roles decision-makers played.Methods Following the Joanna Briggs Institute framework for scoping reviews, we systematically searched for all types of studies in English or French between 2002 and 2023 in: EMBASE, MEDLINE via PubMed, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature. Criteria for inclusion consisted of literature describing health sector QI projects that involved local, regional or system-level decision-makers. Descriptive analysis was performed. Drawing on QI and participatory research literature, the research team developed an inductive data extraction grid to provide a portrait of QI project characteristics, decision-makers’ contributions, and advantages and challenges associated with their involvement.Results After screening and review, we retained 29 references. 18 references described multi-site projects and 11 were conducted in single sites. Local decision-makers’ contributions were documented in 27 of the 29 references and regional decision-makers’ contributions were documented in 12. Local decision-makers were more often active participants in QI processes, contributing toward planning, implementation, change management and capacity building. Regional decision-makers more often served as initiators and supporters of QI projects, contributing toward strategic planning, recruitment, delegation, coordination of local teams, as well as assessment and capacity building. Advantages of decision-maker involvement described in the retained references include mutual learning, frontline staff buy-in, accountability, resource allocation, effective leadership and improved implementation feasibility. Considerations regarding their involvement included time constraints, variable supervisory expertise, issues concerning centralised leadership, relationship strengthening among stakeholders, and strategic alignment of frontline staff and managerial prioritiesConclusions This scoping review provides important insights into the various roles played by decision-makers, the benefits and challenges associated with their involvement, and identifies opportunities for strengthening their engagement. The results of this review highlight the need for practical collaboration and communication strategies that foster partnership between frontline staff and decision-makers at all levels. |
| first_indexed | 2024-03-08T16:36:34Z |
| format | Article |
| id | doaj.art-bd66c5950fdb43cf91d92fb166beba63 |
| institution | Directory Open Access Journal |
| issn | 2399-6641 |
| language | English |
| last_indexed | 2025-03-21T02:17:41Z |
| publishDate | 2024-03-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj.art-bd66c5950fdb43cf91d92fb166beba632024-08-02T16:45:10ZengBMJ Publishing GroupBMJ Open Quality2399-66412024-03-0113110.1136/bmjoq-2023-002522Decision-maker roles in healthcare quality improvement projects: a scoping reviewIsabelle Gaboury0Justin Gagnon1Mylaine Breton2Faculty of Medicine and Health Sciences, Department of Family Medecine and Emergency Medicine, Research Centre of the CIUSSS de l`Estrie-CHUS, Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Longueuil, Quebec, CanadaDepartment of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, CanadaDepartment of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Longueuil, Quebec, CanadaObjectives Evidence suggests that healthcare quality improvement (QI) projects are more successful when decision-makers are involved in the process. However, guidance regarding the engagement of decision-makers in QI projects is lacking. We conducted a scoping review to identify QI projects involving decision-makers published in the literature and to describe the roles decision-makers played.Methods Following the Joanna Briggs Institute framework for scoping reviews, we systematically searched for all types of studies in English or French between 2002 and 2023 in: EMBASE, MEDLINE via PubMed, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature. Criteria for inclusion consisted of literature describing health sector QI projects that involved local, regional or system-level decision-makers. Descriptive analysis was performed. Drawing on QI and participatory research literature, the research team developed an inductive data extraction grid to provide a portrait of QI project characteristics, decision-makers’ contributions, and advantages and challenges associated with their involvement.Results After screening and review, we retained 29 references. 18 references described multi-site projects and 11 were conducted in single sites. Local decision-makers’ contributions were documented in 27 of the 29 references and regional decision-makers’ contributions were documented in 12. Local decision-makers were more often active participants in QI processes, contributing toward planning, implementation, change management and capacity building. Regional decision-makers more often served as initiators and supporters of QI projects, contributing toward strategic planning, recruitment, delegation, coordination of local teams, as well as assessment and capacity building. Advantages of decision-maker involvement described in the retained references include mutual learning, frontline staff buy-in, accountability, resource allocation, effective leadership and improved implementation feasibility. Considerations regarding their involvement included time constraints, variable supervisory expertise, issues concerning centralised leadership, relationship strengthening among stakeholders, and strategic alignment of frontline staff and managerial prioritiesConclusions This scoping review provides important insights into the various roles played by decision-makers, the benefits and challenges associated with their involvement, and identifies opportunities for strengthening their engagement. The results of this review highlight the need for practical collaboration and communication strategies that foster partnership between frontline staff and decision-makers at all levels.https://bmjopenquality.bmj.com/content/13/1/e002522.full |
| spellingShingle | Isabelle Gaboury Justin Gagnon Mylaine Breton Decision-maker roles in healthcare quality improvement projects: a scoping review BMJ Open Quality |
| title | Decision-maker roles in healthcare quality improvement projects: a scoping review |
| title_full | Decision-maker roles in healthcare quality improvement projects: a scoping review |
| title_fullStr | Decision-maker roles in healthcare quality improvement projects: a scoping review |
| title_full_unstemmed | Decision-maker roles in healthcare quality improvement projects: a scoping review |
| title_short | Decision-maker roles in healthcare quality improvement projects: a scoping review |
| title_sort | decision maker roles in healthcare quality improvement projects a scoping review |
| url | https://bmjopenquality.bmj.com/content/13/1/e002522.full |
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