Sustainability of Change within a Quality Improvement Collaborative

描述(由申请人提供)：多组织质量改进协作是实施组织变革的有效策略。未能持续改进是对已投入资源的直接浪费，具有与错失机会相关的成本，并可能影响组织在未来实施更改的能力。然而，缺乏关于协作质量改进以促进变革的长期维持的有效性的研究。此外，我们还不知道哪些属性--组织、创新或环境--是组织在参与质量改进协作后成功维持变化的能力的最重要贡献者。此应用程序是我们研究计划的下一个合乎逻辑的步骤，它探索了 在药物滥用诊所参与NIATx200倡议后，维持它们的组织变革--这是一个旨在测试四种不同执行战略的有效性的质量改进协作，以改善获得和保留治疗的机会。在这项研究中，我们将试图回答一个基本的研究问题：使用NIATx实施战略实施的变化是可持续的吗？我们将利用纵向管理数据和主要信息者访谈，探索位于密歇根州、纽约和华盛顿州的NIATx200诊所在参与质量改进协作后所经历的改善是否持续，并确定影响持续改进的环境、组织和创新相关因素。我们的研究团队在进行成瘾治疗、可持续性和国家政策以及定性研究方面的质量改进和研究方面拥有广泛的专业知识。这些研究结果将有助于执行研究，方法是探索在参与质量改进协作之后的变革的可持续性，并提供对药物滥用诊所内组织变革可持续性的更广泛的了解。目前的项目是在执行研究领域迈出的基础一步，使研究人员和从业人员能够共同改进质量改进，以增强变革的可持续性。

DESCRIPTION (provided by applicant): A multi-organizational quality improvement collaborative is a proven strategy for implementing organizational change. Failure to sustain improvements is a direct waste of invested resources, has costs associated with missed opportunities, and may affect an organization's ability to implement change in the future. Research on the effectiveness of quality improvement collaborative to promote long-term sustainment of change is lacking, however. Moreover, we do not yet understand what attributes--organizational, innovation or environmental-are the most important contributors to the ability of organizations to successfully sustain change following participation in quality improvement collaborative. This application is the next logical step for our research program, and explores the sustainment of organizational change in substance abuse clinics after their participation in the NIATx200 initiative - a quality improvement collaborative designed to test the effectiveness of four different implementation strategies to improve access to and retention in treatment. In this study, we will seek to answer a fundamental research question: Are changes implemented using the NIATx implementation strategy sustainable? Using longitudinal administrative data and key informant interviews, we will explore whether improvements experienced by NIATx200 clinics located in Michigan, New York and Washington were sustained following participation in a quality improvement collaborative, and to identify the environmental, organizational and innovation-related factors that influenced sustained improvements. Our research team has extensive expertise in performing quality improvement and research in addiction treatment, sustainability and state policy, and qualitative research. The findings will contribute to implementation research by exploring sustainment of change after participation in a quality improvement collaborative and by providing a broader understanding of sustainability of organizational change within substance abuse clinics. The current project represents a foundational step in the field of implementation research by enabling researchers and practitioners to improve quality improvement collaborative to enhance sustainability of change.