Key Strategies to Foster Effective Champions for Continuous Quality Improvement in Primary Healthcare Clinics

Context: Healthcare must evolve to overcome challenges and take advantage of opportunities. Continuous quality improvement (CQI) is a promising method for improving the healthcare system and responding effectively to changing patient needs. Champions in CQI refer to individuals who lead or facilitate such initiatives, and they seem to be a key ingredient in promoting quality improvement in Primary healthcare Clinics (PHC).

Objective: This study aims to provide insights and strategies to foster the development of effective champions for CQI in PHC.

Study Design and Analysis: A multiple case study design using a realist evaluation approach was used to refine a program theory. Data were collected through documentary analysis and individual semi-structured interviews. The refined program theory has been used to infer strategies that could promote the emergence of efficient champions for CQI in PHC.

Setting: Cases (4) were defined as champion that promote CQI in PHC. Each case has been informed champion, change agent, peers and managers. The cases have been recruited from PHC in Quebec and Ontario, Canada. Professionals and experts across Canada revised the program theory.

Population studied: Four cases of champions who promote CQI in PHC were identified. The champion and peers targeted by the change were recruited to inform each case.

Results: The data from this study unveiled ten specific strategies that can be applied to promote the emergence of efficient champions in CQI : Establish shared objectives, Prioritize objectives meticulously, Create collaborative spaces, Provide a safe space for experimentation, Implement small but rapid quality improvement cycles, Minimize group size, Resolve barriers and ensure resources are available, Focus on process over behavioural changes, Pace project timelines with vigilance checkpoints, Leverage time as a beneficial factor. These strategies have the potential to foster effective CQI champion PHC.

Conclusions: These strategies provide comprehensive cues for managers and policymakers to promote efficient CQI processes. Fostering efficient champions can improve PHC's adaptability to overcome challenges and take advantage of opportunities.