Effects of Practice Turnover on Primary Care Quality Improvement Implementation
Effects of Practice Turnover on Primary Care Quality Improvement Implementation
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DOI：
10.1177/1062860619844001
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发表时间：
2020-01-01
影响因子：
1.4
通讯作者：
Cohen, Deborah J.
中科院分区：
文献类型：
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作者：
Baron, Andrea N.;Hemler, Jennifer R.;Cohen, Deborah J.
初级保健实践经常从事质量改进（QI），以保持最新和满足质量基准，但营业额影响实践的QI能力的程度没有得到很好的描述。作者研究了参与大规模QI倡议的实践工作人员和外部促进者的定性数据，以了解营业额和QI努力之间的关系。检查发现营业额可以限制实践者以各种方式从事QI活动的能力。当一名员工离职时，留下的员工通常承担额外的责任，随着新员工接受培训或现有员工重新参与，QI的势头会放缓。人员流动改变了工作人员的动态，并可能对建设性的工作关系和团队建设造成障碍。当关键的实践成员离开时，他们可以带走关于QI目的、流程和长期愿景的机构记忆。了解营业额如何影响QI可能有助于实践，以及那些帮助他们与QI，管理营业额的破坏性影响。
Primary care practices often engage in quality improvement (QI) in order to stay current and meet quality benchmarks, but the extent to which turnover affects practices' QI ability is not well described. The authors examined qualitative data from practice staff and external facilitators participating in a large-scale QI initiative to understand the relationship between turnover and QI efforts. The examination found turnover can limit practices' ability to engage in QI activities in various ways. When a staff member leaves, remaining staff often absorb additional responsibilities, and QI momentum slows as new staff are trained or existing staff are reengaged. Turnover alters staff dynamics and can create barriers to constructive working relationships and team building. When key practice members leave, they can take with them institutional memory about QI purpose, processes, and long-term vision. Understanding how turnover affects QI may help practices, and those helping them with QI, manage the disruptive effects of turnover.