Many advocates of quality improvement (QI) suggest that there is a link between an organization's leadership commitment and culture and its ability to implement a QI initiative. This paper reports empirical evidence from a study of QI implementation in Veterans Health Administration (VHA) hospitals that supports this hypothesized linkage. The findings suggest that the extent to which top management becomes directly involved in QI activities determines the degree of QI implementation. Additionally, study findings suggest that a culture emphasizing innovation and teamwork provides an important foundation for implementing a QI initiative. We discuss the implications of these findings for organizational leaders interested in implementing QI.
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References
1.
Shortell SM, O'Brien JL, Carman JM, et al.Assessing the impact of continuous quality improvement/total quality management: concept versus implementation. Health Serv Res1995;30: 377-401.
2.
Carman JM, Shortell SM, Foster RW, et al.Keys for successful implementation of TQM in hospitals. Health Care Manage Rev1996;21:48-60.
3.
Barbour GL, ed. Quality in the Veterans Health Administration: Lessons from the People who Changed the System. San Francisco: Jossey-Bass, 1996.
4.
Young GJ, Charns MP, Barbour GL. Quality improvement in the U.S. Veterans Health Administration. Int J Qual Health Care1997;9:183-188.
5.
Marszalek-Gaucher E, Coffey RJ. Transforming Healthcare Organizations: How to Achieve and Sustain Organizational Excellence. San Francisco: Jossey-Bass, 1990.
6.
Hernandez SR, Kaluzny AD. Organizational innovation and change. In Shortell SM, Kaluzny AD, eds. Healthcare Management: A Text in Organizational Theory and Behavior. 3rd ed.Albany, NY: Delmar, 1994.
7.
Charns MP, Schaeffer MJ. Healthcare Organizations: A Model for Management. Englewood, NJ: Prentice-Hall, 1983.
8.
Galbraith JR. Designing Complex Organizations. Reading, Mass: Addison-Wesley, 1973.
9.
Dean JW, Bowen DA. Management theory and total quality: improving research and practice through theory development. Acad Manage Rev1994;19:392-418.
10.
Zammuto RF, Krakower JY. Quantitative and qualitative studies of organizational culture. Organ Change Dev1991;5:83-114.
11.
Westphal JD, Gulati R, Shortell SM. Customization or conformity? An institutional and network perspective on the content and consequences of TQM adoption. Adm Sci Q1997;42:366-416.
12.
Schein E. Organizational Culture and Leadership. San Francisco: Jossey-Bass, 1985.
