Innovative Process for Department-wide Engagement in Quality Improvement: Experience from the Massachusetts General Hospital
*Yanik J Bababekov, *David C Chang, *Ya-Ching Hung, *Yu-Tien Hsu, *Daniel Hashimoto, *Elan Witkowski, *Alex B Haynes, *John T Mullen, *Allan M Goldstein, *Keith D Lillemoe
Massachusetts General Hospital, Boston, MA
Objective: Quality improvement (QI) initiatives commonly originate ‘top-down’ from senior leadership as staff engagement is often sporadic.
Design: We describe our experience with a technology-enabled ideas contest to encourage participation of multiple stakeholders in a Department of Surgery (DoS) to solicit ideas for QI. We hypothesize that our novel process would stimulate engagement and assist DoS leadership in prioritizing QI initiatives.
Setting: Department of Surgery in a tertiary academic hospital.
Participants: Stakeholders in the DoS.
Interventions: Observational study of a process to engage a DoS in QI. The process had five phases: anonymous online submission of ideas by frontline staff; anonymous online crowd voting to rank ideas on a scale whether the DoS should implement each idea (1=No, 3=Maybe, 5=Yes); ideas with scores>=95thpercentile were invited to submit implementation plans; plans were reviewed by a multi-disciplinary panel to select a winning idea.
Main Outcome Measures: perception on whether the DoS should implement the proposed ideas.
Results: 152 ideas were submitted from 95 staff (n=850, 11.2%). All Divisions (n=12) and all staff roles (n=12) submitted ideas. The greatest number of ideas were submitted by faculty (27.6%), patient service coordinators (18.4%), and residents (17.8%). The most common QI category was access to care (20%). 195 staff (22.9%) cast 3,559 votes. The mean score was 3.5 ±0.5. 10 ideas were objectively invited to submit implementation plans. 1 idea was awarded a grand prize of funding, project management, and leadership buy-in.
Conclusions:A web-enabled ideas contest was successful in engaging faculty, residents, and other critical role groups in QI. Moreover, the contest facilitated prioritization of ideas and identification of QI champions. A ‘bottom-up’ approach to QI is feasible in an academic DoS.
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