Hospital Leadership Important for Quality Improvement

Joseph D. Restuccia, DrPH, MPH Professor and Deans Research Fellow Operations and Technology Management Department Health Sector Management Program Boston University School of Management Boston, MA 02215MedicalResearch.com Interview with:
Joseph D. Restuccia, DrPH, MPH
Professor and Deans Research Fellow
Operations and Technology Management Department
Health Sector Management Program
Boston University School of Management
Boston, MA 02215

MedicalResearch.com: What are the main findings of the study?

Dr. Restuccia: The study resulted in three major findings regarding quality improvement activities in VA.

  • The first is that of the three general categories, to date VA hospitals have devoted the most substantial effort to quality improvement activities (QIAs) related to prevention.
  • The second is that a strong alignment of goals between senior medical center leadership and inpatient medicine service leadership is the greatest predictor of an institution’s use of QIAs.
  • The third is that the medical centers that employ hospitalists, physicians who specialize in the practice of hospital medicine, show the strongest QIA adoption across all three categories.

MedicalResearch.com: Were any of the findings unexpected?

Dr. Restuccia: It was somewhat surprising that use of nurse practitioners or physician assistants did not have any impact of the extent of QIAs implemented.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Restuccia: Our findings demonstrate that the importance of hospital leadership to quality improvement. If leaders are committed to improve quality it is much more likely to happen, especially if they use hospitalists on the medicine service.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Restuccia: As our study design was cross-sectional, future research is needed using a longitudinal study design to better determine causality and to investigate the relationship between contextual factors and QIAs on quality performance. In addition, similar study should be conducted outside of VA to determine the extent our findings are generalizable outside of VA.

Citation:

The Association of Hospital Characteristics and Quality Improvement Activities in Inpatient Medical Services
Restuccia JD, Mohr D, Meterko M, Stolzmann K, Kaboli P.

J Gen Intern Med. 2014 Jan 15. [Epub ahead of print]