Design and Validation of a Questionnaire Assessing the barriers to Physicians' Intervention in Healthcare Quality Improvement Programs

Document Type : Original article

Author

Msc student of Health Management and Economics, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Introduction: Although numerous organizations believe that physician's involvement in quality and safety is important, they have not properly determined how they should be defined, measured, and improved. Since it is essential to improve the quality of healthcare services and increase physician involvement, this study was conducted to evaluate the validity and reliability of a questionnaire on the barriers to physicians' intervention in healthcare quality improvement programs in hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran.
Materials and Methods: The instrument of the study was a researcher-made questionnaire to examine the barriers to physicians' involvement in healthcare quality improvement programs. To determine the face validity of the questionnaire, it was distributed among five specialists in health management and economics and eight medical and nursing students and their opinions were applied. The questionnaire was handed out among 14 physicians with a two-week interval and the content validity ratio index and content validity index were also calculated. To determine the reliability, the interclass correlation coefficient method for quantitative variables and the kappa agreement coefficient method for nominal questions were used. The collected data were analyzed in SPSS 21 software.
Results: The initial item pool consisted of 61 items, which was reduced to 38 items following face and content validity measurement. The questionnaire was composed of 12 sub-scales. Cronbach's alpha coefficient of the questionnaire and the interclass correlation coefficient in two measurements with a two-week interval were obtained at 0.86 and 0.94, respectively.
Conclusion: The designed questionnaire was the first and only valid and reliable specific tool in the field of barriers to physicians' involvement in healthcare quality improvement programs in Iran. This instrument has been used to measure and prioritize the barriers in healthcare centers and improve the quality of health services provided by physicians.

Keywords

References

  1. Sugita JA, Garrett MD. Elder abuse and oral health care providers: an intervention to increase knowledge and self-perceived likelihood to report. J Elder Abuse Neglect. 2012; 24(1):50-64.
  2. Meyers D, Miller T, Genevro J, Zhan C, De La Mare J, et al. EvidenceNOW: balancing primary care implementation and implementation research. Ann Fam Med. 2018; 16(Suppl 1):S5-11.
  3. Gharibi F, Tabrizi JS. Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study. Health Promot Perspect. 2018; 8(2):155-62.
  4. Mathur B, Gupta S, Meena ML, Dangayach GS. Healthcare supply chain management: literature review and some issues. J Adv Manag Res. 2018; 15(3):265-87.
  5. Singh K, Drouin K, Newmark LP, Rozenblum R, Lee J, Landman A, et al. Developing a framework for evaluating the patient engagement, quality, and safety of mobile health applications. Issue Brief (Commonw Fund). 2016; 5:1-11.
  6. Mathews SC, Demski R, Hooper JE, Biddison LD, Berry SA, Petty BG, et al. A model for the departmental quality management infrastructure within an academic health system. Acad Med. 2017; 92(5):608-13.
  7. Willcocks SG, Wibberley G. Exploring a shared leadership perspective for NHS doctors. Leadersh Health Serv (Bradf Engl). 2015; 28(4):345-55.
  8. Ferdosi M, Ziyari FB, Ollahi MN, Salmani AR, Niknam N. Implementing clinical governance in Isfahan hospitals: Barriers and solutions, 2014. J Educ Health Promot. 2016; 5:20.
  9. Nair M, Baltag V, Bose K, Boschi-Pinto C, Lambrechts T, Mathai M. Improving the quality of health care services for adolescents, globally: a standards-driven approach. J Adolesc Health. 2015; 57(3):288-98.
  10. Mainz J, Kristensen S, Bartels P. Quality improvement and accountability in the Danish health care system. Int J Qual Health Care. 2015; 27(6):523-7.
  11. Li J, Hinami K, Hansen LO, Maynard G, Budnitz T, Williams MV. The physician mentored implementation model: a promising quality improvement framework for health care change. Acad Med. 2015; 90(3):303-10.
  12. Van Dooren W, Bouckaert G, Halligan J. Performance management in the public sector: London: Routledge; 2015.
  13. Mosadeghrad AM, Akbari Sari A, Yousefinezhadi T. Evaluation of hospital accreditation method. Tehran Univ Med J. 2017; 75(4):288-98.
  14. Lopez-Campos JL, Navarrete BA, Soriano JB, Soler-Cataluña JJ, González-Moro JMR, Ferrer MEF, et al. Determinants of medical prescriptions for COPD care: an analysis of the EPOCONSUL clinical audit. Int J Chron Obstruct Pulmon Dis. 2018; 13:2279-88.
  15. Kitto S, Goldman J, Etchells E, Silver I, Peller J, Sargeant J, et al. Quality improvement, patient safety, and continuing education: a qualitative study of the current boundaries and opportunities for collaboration between these domains. Acad Med. 2015; 90(2):240-5.
  16. Biancone P, Tradori V, Brescia V, Migliavacca A. Quality and control in the healthcare: a win-win mix? Int J Busin Soc Sci. 2017; 8(7):221-8.
  17. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis. JAMA Intern Med. 2018; 178(10):1317-31.
  18. Jones B, Vaux E, Olsson-Brown A. How to get started in quality improvement. BMJ. 2019; 364:k5408.
  19. Valentini RP. Patient safety and quality improvement: what the pediatric trainee needs to know. Progr Pediatr Cardiol. 2017; 44:47-53.
  20. Desai AD, Starmer AJ. Process metrics and outcomes to inform quality improvement in pediatric hospital medicine. Pediatr Clin North Am. 2019; 66(4):725-37.
  21. Stephen SO, Bula H. Human resource management practices and quality of health care service delivery at Jaramogi Oginga Odinga teaching and referral hospital, Kenya. Hum Res Manag. 2017; 10(10):126-40.
  22. Hooper P, Kocman D, Carr S, Tarrant C. Junior doctors’ views on reporting concerns about patient safety: a qualitative study. Postgrad Med J. 2015; 91(1075):251-6.
  23. Kitto S, Bell M, Peller J, Sargeant J, Etchells E, Reeves S, et al. Positioning continuing education: boundaries and intersections between the domains continuing education, knowledge translation, patient safety and quality improvement. Adv Health Sci Educ Theory Pract. 2013; 18(1):141-56.
  24. Cristancho S, Field E, Lingard L. What is the state of complexity science in medical education research? Med Educ. 2019; 53(1):95-104.
  25. Ogrinc G, Davies L, Goodman D, Batalden P, Davidoff F, Stevens D. Squire 2.0 (Standards for Quality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process. Am J Crit Care. 2015; 24(6):466-73.
Navid No
Volume 24, Issue 78
October 2021
Pages 104-112

Files

Share

How to cite

Statistics