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Effect of COVID-19 on the implementation of a multifaceted intervention to improve teamwork and quality for hospitalized patients: a qualitative interview study.
Terwilliger, Iva A; Manojlovich, Milisa; Johnson, Julie K; Williams, Mark V; O'Leary, Kevin J.
  • Terwilliger IA; Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, 633 N St Clair St, Chicago, IL, USA. iva.terwilliger@northwestern.edu.
  • Manojlovich M; Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, MI, USA.
  • Johnson JK; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Williams MV; Division of Hospital Medicine, Washington University School of Medicine, St. Louis, MO, USA.
  • O'Leary KJ; Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
BMC Health Serv Res ; 22(1): 1379, 2022 Nov 19.
Article in English | MEDLINE | ID: covidwho-2139280
ABSTRACT

BACKGROUND:

Healthcare organizations made major adjustments to deliver care during the COVID pandemic, yet little is known about how these adjustments shaped ongoing quality and safety improvement efforts. We aimed to understand how COVID affected four U.S. hospitals' prospective implementation efforts in an ongoing quality improvement initiative, the REdesigning SystEms to Improve Teamwork and Quality for Hospitalized Patients (RESET) project, which implemented complementary interventions to redesign systems of care for medical patients.

METHODS:

We conducted individual semi-structured interviews with 40 healthcare professionals to determine how COVID influenced RESET implementation. We used conventional qualitative content analysis to inductively code transcripts and identify themes in MAXQDA 2020.

RESULTS:

We identified three overarching themes and nine sub-themes. The three themes were (1) COVID exacerbated existing problems and created new ones. (2) RESET and other quality improvement efforts were not the priority during the pandemic. (3) Fidelity of RESET implementation regressed.

CONCLUSION:

COVID had a profound impact on the implementation of a multifaceted intervention to improve quality and teamwork in four hospitals. Notably, COVID led to a diversion of attention and effort away from quality improvement efforts, like RESET, and sites varied in their ability to renew efforts over time. Our findings help explain how COVID adversely affected hospitals' quality improvement efforts throughout the pandemic and support the need for research to identify elements important for fostering hospital resilience.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2022 Document Type: Article Affiliation country: S12913-022-08795-5

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Humans Language: English Journal: BMC Health Serv Res Journal subject: Health Services Research Year: 2022 Document Type: Article Affiliation country: S12913-022-08795-5