Barriers and Facilitators to the Implementation and Adoption of a Continuous Quality Improvement Program in Surgery: A Case Study

Journal of Continuing Education in the Health Professions (10/10/22) ElChamaa, Rima; Seely, Andrew J.E.; Jeong, Dahn; et al.

Researchers conducted a study in an effort to characterize surgeons' views of barriers and enablers to continuous quality improvement (CQI) programs. The authors enlisted participants across five surgical divisions. They utilized an exploratory case study model featuring semistructured interviews, whose transcripts were analyzed and coded via the Theoretical Domains Framework. Direct coding identified 527 barriers and facilitators to behavior change associated with performance measurement and feedback (PMF) deployment and adoption. Most were coded in the theoretical domains of environmental context/resources, social influences, knowledge and beliefs about consequences. One barrier was that a lack of hospital support forced surgeons to fund PMF programs themselves, while facilitators included having champions to further CQI and seminars to organize discussions on CQI principles and practices. "A key finding of the study was the identification of the influential role of positive deviance seminars as a quality improvement and patient safety mechanism that encourages surgeon engagement in PMF systems," the authors observed.

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