Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders
Objective Variations in the quality and safety of surgical care remain persistent. Efforts to improve are needed, but are themselves variably effective, with often disappointing impacts. When compared with large-scale, multisite and better resourced improvement efforts, the evidence base for small-s...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/1/e002917.full |
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| author | Mary Dixon-Woods Graham Martin Alessandra Giusti Clifford Y Ko |
| author_facet | Mary Dixon-Woods Graham Martin Alessandra Giusti Clifford Y Ko |
| author_sort | Mary Dixon-Woods |
| collection | DOAJ |
| description | Objective Variations in the quality and safety of surgical care remain persistent. Efforts to improve are needed, but are themselves variably effective, with often disappointing impacts. When compared with large-scale, multisite and better resourced improvement efforts, the evidence base for small-scale quality improvement (QI) has remained under-developed and lacking in clarity on good practice. We aimed to identify experienced leaders’ views on the principles that should guide small-scale QI projects in surgery.Methods Two rounds of virtual focus groups were conducted with 10 QI leaders, comprising surgeons, anaesthetists and nurses from three countries (Ireland, the UK and the USA). All participants had formal training in improvement techniques and at least 10 years’ experience leading small-scale QI efforts in surgery. Analysis was informed by the principles of the constant comparative method together with content analysis.Results Analysis of the focus groups identified five principles to prioritise for small-scale surgical QI: ensure high-quality planning before project launch; understand the problem to be solved to define focused project aims; ensure improvement efforts are sensitive to time, capacity and local context; assemble the right improvement team and engage the relevant stakeholders; and use of a clear, structured framework to guide QI is likely to be very helpful.Conclusions This study identifies five principles likely to be useful in guiding better surgical QI in frontline settings. These principles can help inform a structured framework to support small-scale surgical improvement efforts. |
| format | Article |
| id | doaj-art-02812a69bf99467182ad2cac04555c73 |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-02812a69bf99467182ad2cac04555c732025-02-03T19:50:08ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-01-0114110.1136/bmjoq-2024-002917Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leadersMary Dixon-Woods0Graham Martin1Alessandra Giusti2Clifford Y Ko3Department of Public Health and Primary Care, THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Strangeways Research Laboratory, Cambridge, UKStrangeways Research Laboratory, Cambridge, UKStrangeways Research Laboratory, Cambridge, UKDivision of Research and Optimal Patient Care, American College of Surgeons, Chicago, Illinois, USAObjective Variations in the quality and safety of surgical care remain persistent. Efforts to improve are needed, but are themselves variably effective, with often disappointing impacts. When compared with large-scale, multisite and better resourced improvement efforts, the evidence base for small-scale quality improvement (QI) has remained under-developed and lacking in clarity on good practice. We aimed to identify experienced leaders’ views on the principles that should guide small-scale QI projects in surgery.Methods Two rounds of virtual focus groups were conducted with 10 QI leaders, comprising surgeons, anaesthetists and nurses from three countries (Ireland, the UK and the USA). All participants had formal training in improvement techniques and at least 10 years’ experience leading small-scale QI efforts in surgery. Analysis was informed by the principles of the constant comparative method together with content analysis.Results Analysis of the focus groups identified five principles to prioritise for small-scale surgical QI: ensure high-quality planning before project launch; understand the problem to be solved to define focused project aims; ensure improvement efforts are sensitive to time, capacity and local context; assemble the right improvement team and engage the relevant stakeholders; and use of a clear, structured framework to guide QI is likely to be very helpful.Conclusions This study identifies five principles likely to be useful in guiding better surgical QI in frontline settings. These principles can help inform a structured framework to support small-scale surgical improvement efforts.https://bmjopenquality.bmj.com/content/14/1/e002917.full |
| spellingShingle | Mary Dixon-Woods Graham Martin Alessandra Giusti Clifford Y Ko Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders BMJ Open Quality |
| title | Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders |
| title_full | Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders |
| title_fullStr | Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders |
| title_full_unstemmed | Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders |
| title_short | Five principles to prioritise in small-scale surgical quality improvement: a qualitative study of the views of surgical improvement leaders |
| title_sort | five principles to prioritise in small scale surgical quality improvement a qualitative study of the views of surgical improvement leaders |
| url | https://bmjopenquality.bmj.com/content/14/1/e002917.full |
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