Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice
Room for improvement? Leadership, innovation culture and uptake of quality improvement methods in general practice
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DOI：
10.1111/j.1365-2753.2010.01447.x
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发表时间：
2011-04-01
影响因子：
2.4
通讯作者：
Siriwardena, A. Niroshan
中科院分区：
文献类型：
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作者：
Apekey, Tanefa A.;McSorley, Gerry;Siriwardena, A. Niroshan
领导力和创新目前被视为发展和维持高质量护理的基本要素。人们对领导力和创新文化之间的关系以及质量改进方法在一般实践中的应用程度知之甚少。本研究旨在评估一般实践中领导行为、创新文化和采用质量改进方法之间的关系。方法于2007年6月至12月，向英国某郡全科医生质量改善负责人发送自行填写的邮寄问卷。调查问卷包括背景信息、评估领导行为的12项量表、创新文化的7维自评量表，以及关于当前使用质量改进工具和技术的问题。结果共回收问卷63份（62%）。领导行为不常被报道。大多数实践报告了积极的创新文化，其中关系最突出，其次是目标和信息，但在奖励、风险和资源等其他方面的评分较低。领导行为与创新文化之间存在显著正相关（r = 0.57; P < 0.001）。除了临床审核和重大事件分析外，大多数参与实践均未采用质量改进方法。领导行为很少被报道，这与参与全科实践的创新文化有限有关。除了临床和重大事件审计外，很少使用质量改进方法。如果要加速改善卫生保健，就需要支持各种做法，以提高领导技能、鼓励创新和发展改进质量的技能。
BackgroundLeadership and innovation are currently seen as essential elements for the development and maintenance of high-quality care. Little is known about the relationship between leadership and culture of innovation and the extent to which quality improvement methods are used in general practice. This study aimed to assess the relationship between leadership behaviour, culture of innovation and adoption of quality improvement methods in general practice.MethodSelf-administered postal questionnaires were sent to general practitioner quality improvement leads in one county in the UK between June and December 2007. The questionnaire consisted of background information, a 12-item scale to assess leadership behaviour, a seven-dimension self-rating scale for culture of innovation and questions on current use of quality improvement tools and techniques.ResultsSixty-three completed questionnaires (62%) were returned. Leadership behaviours were not commonly reported. Most practices reported a positive culture of innovation, featuring relationship most strongly, followed by targets and information but rated lower on other dimensions of rewards, risk and resources. There was a significant positive correlation between leadership behaviour and the culture of innovation (r = 0.57; P < 0.001). Apart from clinical audit and significant event analysis, quality improvement methods were not adopted by most participating practices.ConclusionsLeadership behaviours were infrequently reported and this was associated with a limited culture of innovation in participating general practices. There was little use of quality improvement methods beyond clinical and significant event audit. Practices need support to enhance leadership skills, encourage innovation and develop quality improvement skills if improvements in health care are to accelerate.