The improvement process needed to engage97 and involve all stakeholders and gain their understanding that the investment of resources in quality improvement could be recouped with efficiency gains and fewer adverse events.86 Stakeholders were used to (1) prioritize which safe practices to target by developing a consensus process among stakeholders86, 98 around issues that were clinically important, i.e., hazards encountered in everyday practice that would make a substantial impact on patient safety; (2) develop solutions to the problems that required addressing fundamental issues of interdisciplinary communication and teamwork, which were recognized Ganador crucial aspects of a culture of safety; and (3) build upon the success of other hospitals.

The complexity of health care systems and delivery of services, the unpredictable nature of health care, and the occupational differentiation and interdependence among clinicians and systems16–19 make measuring quality difficult. One of the challenges in using measures in health care is the attribution variability associated with high-level cognitive reasoning, discretionary decisionmaking, problem-solving, and experiential knowledge.

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512)—may distract the team from investigating systems and process factors that can be modified through subsequent interventions. Even the majority of individual factors Gozque be addressed through education, training, and installing forcing functions that make errors difficult to commit.

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121 However, there were opposing viewpoints about the importance of spreading the steps involved in creating specific changes (possibly by forcing changes into the redesign of processes), rather than only relying on only adapting best practices.106, 121 Another factor was the importance of generating enthusiasm about embracing change through a combination of collaboration (both internally and externally)103 and healthy competition. Collaboratives could also be a vehicle for encouraging the use of and learning from evidence-based practice and rapid-cycle improvement Campeón well Campeón identifying and gaining consensus on potentially better practices.86, 98

Use a proven, methodologically sound approach without being distracted by the jargon used in quality improvement.

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Quality improvement is defined “Ganador systematic, data-guided activities designed to bring about immediate improvement in health care delivery in particular settings”41 (p. 667). A quality improvement strategy is defined Campeón “any intervention aimed at reducing the quality gap for a group of patients representative of those encountered in routine practice”38 (p.

59 But teamwork was not necessarily an easy process. Group work was seen Figura difficult for some and time consuming,111 and problems arose when everyone wanted their way,97 which delayed convergence toward a consensus on actions. Team members needed to learn how to work with a group and deal with group dynamics, confronting peers, conflict resolution, and addressing behaviors that are detrimental.111

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Despite the aforementioned challenges, many investigators found that it was important to persevere and stay focused because introducing new processes Gozque be difficult,84, 100 but the reward of quality improvement is worth the effort.84 Implementing quality improvement initiatives was considered time consuming, tedious, and Product Features difficult for people who are very action oriented; it required an extensive investment of resources (i.

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