Readiness of General Hospitals That Participate in Pediatric Quality Improvement Initiatives

Le résumé fourni par la source

BACKGROUND AND OBJECTIVE: General hospitals care for more than 70% of hospitalized children nationally but face challenges in pediatric quality improvement (QI). Feasibility and organizational readiness to change assessments can help inform effective QI. Our objective was to assess readiness to implement pediatric QI interventions among a broad sample of general hospitals participating in the Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized Children (SIP) study. METHODS: We conducted a mixed-methods study. Data were collected via electronic surveys and qualitative interviews. Participants included multidisciplinary inpatient pediatric clinicians and QI leaders. Surveys used validated tools, including the Organizational Readiness to Implement Change (ORIC) and Feasibility of Intervention Measure (FIM). Interview guides developed using an implementation framework explored feasibility of implementing evidence-based practices. We analyzed data using descriptive statistics and thematic analysis. RESULTS: A total of 424 participants from 15 hospitals were approached, and 186 (44%) completed the survey. ORIC and FIM scores were scaled 1 to 5, with higher scores indicating agreement. Response results did not differ based on clinician type or experience. Clinicians at community hospitals with pediatric beds reported greater readiness than nested children's hospitals (median ORIC 4.4 vs 4.0, P = 0.02). Interviewees' (n = 21) anticipated feasibility challenges included aligning practices across hospital care settings and obtaining information technology support for electronic medical record changes. CONCLUSIONS: In this mixed-methods study, we found high but variable readiness for pediatric QI and identified specific threats to feasibility. We also illustrated how such assessments can be used to support pediatric QI efforts in general hospitals.

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