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Building the Case for Quality Improvement in the Health Care Industry: A Focus on Goals and Training

Field, Joy M. PhD; Heineke, Janelle DBA; Langabeer, James R. PhD; DelliFraine, Jami L. PhD

doi: 10.1097/QMH.0000000000000036
Original Articles

Health care organizations are under intense pressure to improve the efficiency and effectiveness of care delivery and, increasingly, they are using quality improvement teams to identify and target projects to improve performance outcomes. This raises the question of what factors actually drive the performance of these projects in a health care environment. Using data from a survey of health care professionals acting as informants for 244 patient care, clinical-administrative, and nonclinical administrative quality improvement project types in 93 health care organizations, we focus on 2 factors—goal setting and quality training—as potential drivers of quality improvement project performance. We find that project-level goals and quality training have positive associations with process quality, while organizational-level goals have no impact. In addition, the relationship between project-level goals and process quality is stronger for patient care projects than for administrative projects. This indicates that the motivational and cognitive effects of goal setting are greater for projects that involve interactions with clinicians than for ones that involve interactions with other staff. Although project-level goal setting is beneficial for improving process quality overall, our findings suggest the importance of being especially attentive to goal setting for projects that impact direct patient care.

Carroll School of Management, Boston College, Chestnut Hill, Massachusetts (Dr Field); Boston University School of Management, Boston University, Boston, Massachusetts (Dr Heineke); University of Texas School of Public Health, University of Texas-Houston, Houston (Dr Langabeer II); and Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia (Dr DelliFraine).

Correspondence: Jami L. DelliFraine, PhD, Department of Health Administration, Virginia Commonwealth University, Grant House, 1008 East Clay St, PO Box 980203, Richmond, VA 23298 (

The authors declare that they have no conflict of interest.

© 2014Wolters Kluwer Health | Lippincott Williams & Wilkins