Table 5 Themes identified from interviews with implementation experts on how to analyse and address determinants for performing QI initiatives
Communication: It seems important to communicate about the initiative to different stakeholders at different levels both inside and outside the organisation. Depending on the stakeholder, this communication differs in terms of how much information the project leader provides, which information is provided and the way in which the information is provided. Experts talked about ‘speaking the language of the stakeholder’. It is important to express what is expected from stakeholders, to periodically inform them about progress and to listen carefully to what they say about the initiative. Creating room for stakeholders to ask questions about the initiative is also considered important. A communication plan can facilitate the structuring of this communication. Keep it small: Experts emphasised the importance of keeping an initiative small, both in terms of the goal(s) and the participants and departments to be included. Project leaders should look at the initiative as one part of the whole QI process in their institution and try to improve something in their microsystem. Successful implementation in this context can lead to future spread and sustainability. Influence and concern: This theme relates to focusing on determinants that can be influenced by healthcare professionals as improvement leaders, rather than determinants that lie beyond their influence. Determinants that can only be addressed with disproportionate effort will result in a disbalance between effort and result, which can lead to an energy leak. Learning by doing: Experts frequently noticed that the implementation of an QI initiative is a process that is equally or even more important than the beneficial outcomes. One expert said: ‘the journey itself is much more important than your end goal. Projects can fail in terms of outcomes, but you can learn so much of that by putting value on the process’. By seeing the implementation process as a learning process, healthcare professionals can learn for future initiatives |