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Thursday, September 26, 2019

Qualitative proposal research regarding ARE DOCTORS SUPPORTIVE OR Thesis

Qualitative proposal research regarding ARE DOCTORS SUPPORTIVE OR OBSTICLES IN QUALITY IMPROVMENT PROGRAM - Thesis Example Physicians often view CQI as a threat to professional autonomy (McLaughlin & Kaluzny, 1990) and are skeptical that a management technique can improve patient outcomes. Structural barriers, including inadequate training (Shortell et al., 1995), longstanding social norms (Mittman, Tonesk, & Jacobson, 1992), and the fact that many physicians are independent providers (Chan & Ho, 1997), can also impede physician involvement in CQI and other changes in health care. Physician involvement in CQI becomes critical as quality improvement initiatives turn from administrative functions (e.g., streamlining outpatient registration) to clinical functions (e.g., increasing adherence to clinical practice guidelines). Unfortunately, traditional approaches to physician behavior change are unlikely to increase physician involvement in CQI. A meta-analysis of 102 studies examining the efficacy of continuing medical education strategies found that our most heavily used interventions, educational materials and conferences, tend to have little impact on physician behavior or patient outcomes in health care (Davis, Thomson, Oxman, & Haynes, 1995). There is growing recognition that the success of interventions may depend in part on individual readiness to change (Armstrong, Reyburn, & Jones, 1996; Cantillon & Jones, 1999; Davis et al., 1995). The transtheoretical model (TTM, also known as the stage model), one of the leading approaches to health behavior change, offers a promising approach to behavior change among health care professionals. The model systematically integrates the following four theoretical concepts central to change: The TTM understands change as progress, over time, through a series of stages: precontemplation, contemplation, preparation, action, and maintenance. Nearly 20 years of research on a variety of health behaviors have identified processes of change that work best in each stage to facilitate progress. This research can serve as a

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