Affiliation:
1. Department of Global Health Peking University School of Public Health Beijing China
2. Institute for Global Health and Development Peking University Beijing China
3. China Cardiovascular Association and China Chest Pain Centers Suzhou China
4. Division of Cardiology Peking University First Hospital Beijing China
5. RTI International Waltham MA
6. Division of Cardiovascular Medicine School of Medicine University of North Carolina at Chapel Hill NC
Abstract
Background
Medical staff represent critical stakeholders in the process of implementing a quality improvement (QI) program. Few studies, however, have examined factors that influence medical staff engagement and perception regarding QI programs.
Methods and Results
We conducted a nationally representative survey of a QI program in 6 cities in China. Quantitative data were analyzed using multilevel mixed‐effects linear regression models, and qualitative data were analyzed using the framework method. The engagement of medical staff was significantly related to knowledge scores regarding the specific content of chest pain center accreditation (β=0.42; 95% CI, 0.27–0.57). Higher scores for inner motivation (odds ratio [OR], 1.79; 95% CI, 1.18–2.72) and resource support (OR, 1.52; 95% CI, 1.02–2.24) and lower scores for implementation barriers (OR, 0.81; 95% CI, 0.67–0.98) were associated with improved treatment behaviors among medical staff. Resource support (OR, 4.52; 95% CI, 2.99–6.84) and lower complexity (OR, 0.81; 95% CI, 0.65–1.00) had positive effects on medical staff satisfaction, and respondents with improved treatment behaviors were more satisfied with the QI program. Similar findings were found for factors that influenced medical staff’s assessment of QI program sustainability. The qualitative analysis further confirmed and supplemented the findings of quantitative analysis.
Conclusions
Clarifying and addressing factors associated with medical staff’s engagement and perception of QI programs will allow further improvements in quality of care for patients with acute coronary syndrome. These findings may also be applicable to other QI programs in China and other low‐ and middle‐income countries.
Registration
URL:
https://www.chictr.org.cn/
; Unique identifier: Chi‐CTR2100043319.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine