Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability
Background: Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200).
Methods: A mixed linear model repeated measures analysis was applied to matched staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III).
Results: For Model I, staff perceptions of total SC increased throughout most of the study (t1,4=-6.74, p<.0001; t2,4=-3.100, p<.036; t3,4=-0.23, p=ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t=-2.23, p=.026), staff job function (t=-3.27, p=.001), and organizational administrators (t=-3.50, p=.001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t=-3.09, p<.002) and being in a free-standing clinic (t=-2.06, p<.04) on staff perceptions of total SC.
Conclusion: Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.
Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141
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This is a list of supplementary files associated with this preprint. Click to download.
Additional File 1: Sustainability Construct by Assessment Timing and Level of Focus
Additional File 2: Blank British National Health Service Survey
Additional File 3: British National Health Services Sustainability Index Scoring Guide
Additional File 4: StaRI Checklist
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Influence of Participation in a Quality Improvement Collaborative on Staff Perceptions of Organizational Sustainability
Posted 04 Jan, 2021
On 07 Jan, 2021
On 18 Dec, 2020
On 15 Dec, 2020
On 08 Dec, 2020
On 24 Nov, 2020
On 24 Nov, 2020
On 24 Nov, 2020
On 11 Nov, 2020
Received 24 Oct, 2020
On 20 Sep, 2020
Received 23 Aug, 2020
Invitations sent on 30 Jul, 2020
On 30 Jul, 2020
On 23 Jul, 2020
On 22 Jul, 2020
On 22 Jul, 2020
On 10 Jul, 2020
Received 05 Jul, 2020
Received 02 Jul, 2020
On 29 Jun, 2020
On 08 Jun, 2020
Invitations sent on 08 Jun, 2020
On 04 Jun, 2020
On 03 Jun, 2020
On 03 Jun, 2020
On 05 May, 2020
Received 01 May, 2020
Received 11 Apr, 2020
On 10 Apr, 2020
Invitations sent on 06 Apr, 2020
On 06 Apr, 2020
On 01 Mar, 2020
On 29 Feb, 2020
On 29 Feb, 2020
On 28 Feb, 2020
Background: Sustainability capacity (SC), which is an organization’s ability to implement and maintain change, is influenced by internal attributes, environmental contextual influencers, and intervention attributes. Temporal changes in staff SC perceptions, as well as the influence of quality improvement collaborative (QIC) participation, has generally not been explored. This project addresses this gap, measuring staff SC perceptions at four time points (baseline and every 9 months) for clinics participating in an intervention – the Network for the Improvement of Addiction Treatment QIC initiative (called NIATx200).
Methods: A mixed linear model repeated measures analysis was applied to matched staff members (n=908, representing 2,329 total cases) across the evaluation timeframe. Three separate statistical models assessed potential predictors of SC perceptions: Time (Models I-III); NIATx200 intervention, staff job function, and tenure (Models II &III); and NIATx200 participation hours and four organizational variables (Model III).
Results: For Model I, staff perceptions of total SC increased throughout most of the study (t1,4=-6.74, p<.0001; t2,4=-3.100, p<.036; t3,4=-0.23, p=ns). Model II did not change Model I’s overall Time effect, but combined NIATx200 services (t=-2.23, p=.026), staff job function (t=-3.27, p=.001), and organizational administrators (t=-3.50, p=.001) were also significantly associated with greater perceptions of total SC. Inclusion of additional variables in Model III demonstrated the importance of a higher participation level (t=-3.09, p<.002) and being in a free-standing clinic (t=-2.06, p<.04) on staff perceptions of total SC.
Conclusion: Although staff exposure to sustainability principals was minimal in NIATx200, staff perceptions about their organization’s SC significantly differed over time. However, an organization’s participation level in a QIC became the principal predictor of staff SC perceptions, regardless of other factors’ influence. Given these findings, it is possible to develop and introduce specific sustainability content within the structure of a QIC to assess the impact on staff SC perceptions over time and the sustainment of organizational change.
Trial Registration: ClinicalTrials.gov, NCT00934141 Registered July 6, 2009. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT00934141
Figure 1