# Employees in the municipal healthcare service experiences with participation in quality improvement collaboratives and the use of the Quality Improvement Model: a qualitative study

## TL;DR

This study explores how healthcare employees use a quality improvement model and participate in digital collaboratives to enhance healthcare services.

## Contribution

The study provides new insights into the practical use of a quality improvement model in digital collaboratives within municipal healthcare.

## Key findings

- Employees emphasized the importance of proper use of the Quality Improvement Model.
- Digital collaboratives and process guidance helped sustain progress in quality improvement.
- Leadership involvement is crucial for encouraging employee participation and implementing changes.

## Abstract

Quality improvement is a continuous process, and quality improvement collaboratives are frequently used worldwide to promote quality improvement. A Quality Improvement Model is recommended for performing quality improvement work systematically to ensure both quality and patient safety in healthcare services. The aim of this study was to gain a deeper understanding of municipal healthcare service employees’ use of the enhanced first phase of the Quality Improvement Model and to explore their experiences of participation in digital quality improvement collaboratives.

A qualitative design with focus group interviews was used. A semistructured interview guide was developed by the authors prior to the focus group interviews with the goal of obtaining relevant data for this study. Reflexive thematic analysis was used to analyse the focus group interviews.

Three themes were revealed by the analysis: learning in community with others in a digital quality improvement collaborative; it is important to use the Quality Improvement Model properly; and the establishment of a culture that is conducive to quality improvement work is important. These themes highlight the necessity of ensuring that both managers and employees are familiar with the Quality Improvement Model used in quality improvement projects and understanding the importance of dedicating sufficient time to the preparation phase. Digital quality improvement collaboratives sessions and interim process guidance were key to sustaining momentum and driving progress in the quality improvement work.

The Quality Improvement Model is suitable for quality improvement work; furthermore, by using the model, participants were able to remain in the preparation phase longer, thereby refining their quality improvement work and making the project more robust. The digital quality improvement collaborative sessions and the process guidance provided between the sessions were important with respect to the progress of quality improvement work. Leadership anchoring and involvement are essential with respect to efforts to encourage employees to participate in quality improvement work and implement the changes required by such work.