Deliberation Makes a Difference: Preparation Strategies for TeamSTEPPS Implementation in Small and Rural Hospitals

Xi Zhu; Jure Baloh; Marcia M Ward; Greg L Stewart

doi:10.1177/1077558715607349

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Deliberation Makes a Difference: Preparation Strategies for TeamSTEPPS Implementation in Small and Rural Hospitals

Journal article

Peer reviewed

Deliberation Makes a Difference: Preparation Strategies for TeamSTEPPS Implementation in Small and Rural Hospitals

Xi Zhu, Jure Baloh, Marcia M Ward and Greg L Stewart

Medical care research and review, Vol.73(3), pp.283-307

06/2016

DOI: 10.1177/1077558715607349

PMCID: PMC4833673

PMID: 26429835

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https://www.ncbi.nlm.nih.gov/pmc/articles/4833673View

Open Access

Abstract

Small and rural hospitals face special challenges to implement and sustain organization-wide quality improvement (QI) initiatives due to limited resources and infrastructures. We studied the implementation of TeamSTEPPS, a national QI initiative, in 14 critical access hospitals. Drawing on QI and organization development theories, we propose five strategic preparation steps for TeamSTEPPS: assess needs, reflect on the context, set goals, develop a shared understanding, and select change agents. We explore how hospitals' practices correspond to suggested best practices by analyzing qualitative data collected through quarterly interviews with key informants. We find that the level of deliberation was a key factor that differentiated hospitals' practices. Hospitals that were more deliberate in preparing for the five strategic steps were more likely to experience engagement, perceive efficacy, foresee and manage barriers, and achieve progress during implementation. We discuss potential steps that hospitals may take to better prepare for TeamSTEPPS implementation.

Program Development

Quality Improvement - organization & administration

United States

Humans

Interviews as Topic

Organizational Innovation

Hospitals, Rural - organization & administration

Needs Assessment - organization & administration

Hospital Administrators

Practice Guidelines as Topic

Details

Title: Subtitle: Deliberation Makes a Difference: Preparation Strategies for TeamSTEPPS Implementation in Small and Rural Hospitals
Creators: Xi Zhu - University of Iowa, Iowa City, IA, USA xi-zhu@uiowa.edu
Jure Baloh - University of Iowa, Iowa City, IA, USA
Marcia M Ward - University of Iowa, Iowa City, IA, USA
Greg L Stewart - University of Iowa, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Medical care research and review, Vol.73(3), pp.283-307
DOI: 10.1177/1077558715607349
PMID: 26429835
PMCID: PMC4833673
NLM abbreviation: Med Care Res Rev
ISSN: 1077-5587
eISSN: 1552-6801
Publisher: United States
Grant note: R18 HS018396 / AHRQ HHS R03 HS024112 / AHRQ HHS
Language: English
Date published: 06/2016
Academic Unit: Health Management and Policy; Management and Entrepreneurship ; Internal Medicine
Record Identifier: 9984063128002771

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3 Times Cited - Web of Science