Building motivation to participate in a quality improvement collaborative in NHS hospital trusts in Southeast England: a qualitative participatory evaluation.
Mirza Lalani, Kate Hall, Mirek Skrypak, Chris Laing, John Welch, Peter Toohey, Sarah Seaholme, Thomas Weijburg, Laura Eyre, Martin Marshall
Author Information
Mirza Lalani: Research Department of Primary Care and Population Health, University College London, London, UK.
Kate Hall: UCLPartners, London, UK.
Mirek Skrypak: UCLPartners, London, UK.
Chris Laing: The Royal Free London NHS Foundation Trust, London, UK.
John Welch: University College London Hospitals NHS Foundation Trust, London, UK.
Peter Toohey: UCLPartners, London, UK.
Sarah Seaholme: UCLPartners, London, UK.
Thomas Weijburg: UCLPartners, London, UK.
Laura Eyre: Research Department of Primary Care and Population Health, University College London, London, UK.
Martin Marshall: Research Department of Primary Care and Population Health, University College London, London, UK.
OBJECTIVES: This study explores the barriers and facilitators that impact on the motivation of practitioners to participate in a quality improvement collaborative. DESIGN: A qualitative and formative evaluation using a participatory approach, the researcher-in-residence model which embraces the concept of 'coproducing' knowledge between researchers and practitioners using a range of research methods such as participant observation, interviews and documentary analysis. The design, creation and application of newly generated evidence are facilitated by the researcher through negotiation and compromise with team members. PARTICIPANTS: Senior and middle managers, doctors and nurses. SETTING: Two hospitals in Southeast England participating in a Patient Safety Improvement Collaborative and the facilitator (host) of the collaborative, based in Central London. RESULTS: The evaluation has revealed facilitators and barriers to motivation categorised under two main themes: (1) inherent motivation and (2) factors that influence motivation, interorganisational and intraorganisational features as well as external factors. Facilitators included collaborative 'champions,' individuals who drove the quality improvement agenda at a local level, raising awareness and inspiring colleagues. The collaborative itself acted as a facilitator, promoting shared learning as well as building motivation for participation. A key barrier was the lack of board engagement in the participating National Health Service organisations which may have affected motivation among front-line staff. CONCLUSIONS: Collaboratives maybe an important way of engaging practitioners in quality improvement initiatives. This study highlights that despite a challenging healthcare environment in the UK, there remains motivation among individuals to participate in quality improvement programmes as they recognise that improvement approaches may facilitate positive change in local clinical processes and systems. Collaboratives can harness this individual motivation to facilitate spread and adoption of improvement methodology and build engagement across their membership.
