From Theory to Implementation: Adaptations to a Quality Improvement Initiative According to Implementation Context

As countries continue to invest in quality improvement (QI) initiatives in health facilities, it is important to acknowledge the role of context in implementation. We conducted a qualitative study between February 2019 and January 2020 to explore how a QI initiative was adapted to enable implementation in three facility types: primary health centres, public hospitals and private facilities in Lagos State, Nigeria. Despite a common theory of change, implementation of the initiative needed to be adapted to accommodate the local needs, priorities and organisational culture of each facility type. Across facility types, inadequate human and capital resources constrained implementation and necessitated an extension of the initiative’s duration. In public facilities, the local governance structure was adapted to facilitate coordination, but similar adaptations to governance were not possible for private facilities. Our findings highlight the importance of anticipating and planning for the local adaptation of QI initiatives according to implementation environment.

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Improving Access and Satisfaction with Spiritual Care in the Hospice Setting

OMEGA - Journal of Death and Dying ◽

10.2190/om.67.1-2.k ◽

2013 ◽

Vol 67 (1-2) ◽

pp. 97-107 ◽

Cited By ~ 1

Author(s):

Daleasha Hall ◽

Mary A. Shirey ◽

David C. Waggoner

Keyword(s):

Quality Improvement ◽

Education Program ◽

Spiritual Care ◽

Interdisciplinary Teams ◽

Quality Improvement Initiative ◽

Full Time ◽

Sacred Heart ◽

Care Services ◽

Allocation Of Time

Hospice of Sacred Heart, an agency of PeaceHealth Oregon, experienced a dramatic increase in its census beginning in 2007. The spiritual care team noticed the number of referrals was decreasing while the census was increasing. A quality improvement initiative was conducted, including a staff survey, an education program about spirituality and the role of chaplains on interdisciplinary teams in the hospice setting, and an audit of the chaplain's daily allocation of time. These actions resulted in an increase in the use of spiritual care services by patients and staff and the addition of two full-time, benefited chaplain positions.

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The role of chief executive officers in a quality improvement initiative: a qualitative study

BMJ Open ◽

10.1136/bmjopen-2012-001731 ◽

2013 ◽

Vol 3 (1) ◽

pp. e001731 ◽

Cited By ~ 12

Author(s):

Anam Parand ◽

Sue Dopson ◽

Charles Vincent

Keyword(s):

Quality Improvement ◽

Qualitative Study ◽

Chief Executive Officers ◽

Chief Executive ◽

Quality Improvement Initiative ◽

Executive Officers

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Accountability in the Ghanaian local governance structure: probing the role of external auditing

Problems and Perspectives in Management ◽

10.21511/ppm.18(4).2020.38 ◽

2020 ◽

Vol 18 (4) ◽

pp. 475-485

Author(s):

Haruna Maama ◽

Ferina Marimuthu

Keyword(s):

Internal Control ◽

Local Governance ◽

Governance Structure ◽

Annual Reports ◽

External Auditors ◽

Performance Auditing ◽

Public Sector Managers ◽

Auditor General ◽

Management Contract

The roles of external auditors have been under the spotlight due to the strategic positions they occupy to ensure accountability by public sector managers. This study examines the role of the external auditors in the accountability regime of the Ghanaian local governance structure. The study analyzed the annual reports of the Auditor General (AG) on all the metropolitan, municipal, and district assemblies (MMDAs) in Ghana from 2010 to 2018 through a content analysis method. The analysis revealed that Ghanaian audit activities had mainly focused on internal control effectiveness, cash management, contract management, revenue management, expenditure management, payroll management, and procurement management. However, the study found that the focus of the external auditors kept expanding as the years progressed. The evidence showed that the auditors excluded performance audits in their scope of work. The findings of the study further revealed that the MMDAs had recurring, repetitive, and common audit queries, comprising cash; procurement and stores; contract and tax irregularities. Besides, the audit recommendations were in response to the specific audit queries on the various financial and operational irregularities. Based on the analysis, the study concludes that the external auditing in Ghana has marginally contributed to accountability in the MMDAs. The study recommends that the scope of the external audit should include performance auditing.

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Supporting quality care in general practice: The collaboratives approach

Australian Journal of Primary Health ◽

10.1071/py08021 ◽

2008 ◽

Vol 14 (2) ◽

pp. 46 ◽

Cited By ~ 3

Author(s):

Catuscia Buiso ◽

Bill Newton

Keyword(s):

Primary Care ◽

General Practice ◽

Quality Improvement ◽

Chronic Disease ◽

Quality Care ◽

Quality Improvement Initiative ◽

Building Practice ◽

The Impact ◽

International Phenomenon

An important role of divisions of general practice is to support general practice to build capacity for the delivery of quality care. The purpose of this paper is to discuss the National Primary Care Collaboratives Program and the impact this quality improvement initiative has had on building practice capacity to achieve improvements in the management of chronic disease. "The Collaboratives" are an international phenomenon, which, over the last three years, has been implemented in Australia and has achieved impressive results consistent with the success documented in other countries. This paper explores the key elements contributing to the success of the program and discusses the opportunities that have strengthened the ability of participating divisions to support general practice to deliver quality care.

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