From: The role of organizational research in implementing evidence-based practice: QUERI Series
Organizational structure |
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• Size of organizational unit(s) (e.g., facilities, beds, providers) |
• Academic affiliation (e.g., scope of training programs, integration of trainees in care delivery) |
• Service availability (e.g., differentiation and scope of services, general and specialty services, access to specialized units) |
• Configuration (e.g., service lines, teams, integrated networks) |
• Staffing/skill-mix (e.g., types of providers, level of training/experience) |
• Leadership structure/authority (e.g., leadership quality, hierarchical vs. vertical structures, ownership, practice autonomy, organizational influence) |
• Financial structure (e.g., health plan, reimbursement, compensation structures) |
• Availability of basic and specialized service, equipment or supplies |
• Resource allocation methods, resource sufficiency, and equitable distribution |
• Organizational culture (e.g., group culture, teamwork, risk-taking, innovativeness) |
• Work environment/organizational climate |
• Knowledge, attitudes, beliefs of managers, providers, staff (e.g., organizational readiness to change) |
• Level of organizational stress/tensions, degree of hassles |
Organizational Processes |
• Care management processes (e.g., practice arrangements, use of care managers to coordinate services and follow-up) |
• Referral procedures (e.g., demonstration of need for referral, identification of appropriate provider resources, nature of handoffs, communication of referral results/outcomes, returns) |
• Organizational supports for clinical decision-making (e.g., use of reminders, disease-specific checklists or computerized templates, electronic co-signing; designated staff implementing general or disease-specific protocols) |
• Recognition/rewards, incentive systems, pay-for-performance |
• Communication processes, procedures, quality of interactions |
• Relationships (nature of roles and responsibilities, interpersonal styles,) |
• Problem solving, conflict management, communication and response to expectations |
Organizational Outcomes |
• Process quality measures (e.g., percentage of eligible diabetics receiving foot sensation exams) |
• Intermediate outcome measures (e.g., glycemic control among diabetics in the entire practice) |
• Disease-related outcomes (e.g., complication rates, disease-specific morbidity and mortality) |
• Global health status measures (e.g., functional status) |
• Utilization measures (e.g., ambulatory care sensitive admission rates, guideline-recommended use of services at the organizational level) |
• Workflow or efficiency measures (e.g., wait times, workload) |
• Costs (e.g., costs of the QI intervention and its implementation at the organizational level) |