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Quality‐based procedures in Ontario: exploring health‐care leaders' responses
Author(s) -
Baxter Pamela,
Cleghorn Laura,
Alvarado Kim,
Cummings Greta,
Kennedy Deborah,
McKey Colleen,
Pfaff Kathy
Publication year - 2016
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.12271
Subject(s) - unintended consequences , focus group , nursing , qualitative research , health care , quality (philosophy) , change management (itsm) , medicine , exploratory research , qualitative property , nursing management , public relations , business , political science , marketing , sociology , social science , philosophy , epistemology , lean manufacturing , machine learning , computer science , law , anthropology
Aim To examine health‐care leaders' initial response to the implementation of orthopaedic quality based procedures ( QBP s) in hospitals across Ontario, Canada. Background In 2012, Ontario, Canada shifted 91 hospitals to a patient‐based funding ( PBF ) approach. This approach funds health‐care organisations based on the number of patients treated with select procedures known as QBP s. Methods An exploratory descriptive design was employed to better understand health‐care leaders' early implementation experiences. Seventy organisational leaders from 20 hospitals participated in six focus groups and four interviews to discuss their initial responses to the implementation of two QBP s (primary unilateral hip replacement and primary unilateral knee replacement). Qualitative data underwent content analysis. Findings Three key major themes emerged; (1) responding to change, (2) leading the change and (3) managing the change. Within each of these themes, barriers and benefits were identified. Conclusion Leaders are accepting of PBF and QBP s. However, challenges exist that require further exploration including the need for a strong infrastructure, accurate and timely clinical and financial data, and policies to prevent unintended consequences. Implications for nursing management Implementing QBP s requires careful planning, adequate and appropriate resources, vertical and horizontal communication strategies, and policies to ensure that unintended consequences are avoided and positive outcomes achieved.