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Creating a Quality-Improvement Dialogue: Utilizing Knowledge From Frontline Staff, Managers, and Experts to Foster Health Care Quality Improvement

VA Center for Mental Health Care and Outcomes Research, North Little Rock, Arkansas, USA

JoAnn E. Kirchner

VA South Central Mental Illness Research, Education, and Clinical Center, North Little Rock, Arkansas, USA

Laura M. Bonner

VA Puget Sound Health Care System, Seattle, Washington, USA

Jacqueline J. Fickel

VA HSR&D Center of Excellence for the Study of Health Care Provider Behavior, Sepulveda, California, USA

Mona J. Ritchie

VA Mental Health Quality Enhancement Research Initiative Coordinating Center, North Little Rock, Arkansas, USA

Carol E. Simons

VA Puget Sound Health Care System, Seattle, Washington, USA

Elizabeth M. Yano

VA HSR&D Center of Excellence for the Study of Health Care Provider Behavior, Sepulveda, California, USA

There is a growing consensus that a hybrid of two common approaches to quality improvement (QI), local participatory QI and expert QI, might be the best method for achieving quality care. Achieving such a hybrid requires that content experts establish an ongoing dialogue with both frontline staff members and managers. In this study we examined frontline staff members' and managers' preferences regarding how to conduct such a dialogue, and we provide practical suggestions for implementation. The two groups shared a number of preferences (e.g., verbal face-to-face exchanges, discussions focused on quality of care). There were also some differences. For example, although managers were interested in discussions of business aspects (e.g., costs), frontline staff members were concerned with workload issues. Finally, although informants acknowledged that engaging in a QI dialogue was time consuming, they also believed it was essential if health care organizations are to improve the quality of care they provide.

Key Words: health care decision making • health care professionals • health care workplace • quality improvement • research dissemination and utilization • research implementation

This version was published on February 1, 2009

Qualitative Health Research, Vol. 19, No. 2, 229-242 (2009)
DOI: 10.1177/1049732308329481


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