HIDDEN IN PLAIN VIEW: BARRIERS TO QUALITY IMPROVEMENT
DESPITE A VAST AMOUNT OF KNOWLEDGE about the technical methods of improving quality and safety in health care, rates of success have been highly variable within and across organizations. In our work with many health care leaders and organizations, our observation has been that relational rather than technical issues are the most common barriers to improvement.
This may seem paradoxical in an industry devoted to healing relationships. But we have observed that the complexity and stress so prevalent in health care settings lead to frequent problems in working relationships at all levels of interaction: interpersonal, team, interdepartmental and interorganizational.
Multiple research studies and analyses have suggested that contextual factors (such as quality of relationships, communication, leadership style, organizational culture, team process and behaviors, etc.) are critical facilitators or impediments for change.
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