Banca de DEFESA: ELIANE PEREIRA DA SILVA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ELIANE PEREIRA DA SILVA
DATE: 18/01/2024
TIME: 14:00
LOCAL: On-line
TITLE:

Motivation and competencies for the success of health care quality improvement projects 

KEY WORDS:

Health Care Quality. Quality improvement. Motivation.  Health Education. Public Health.  Health Services. Professional Competence.

PAGES: 115
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: the success of health quality improvement projects depends on the engagement of professionals who work in patient care and knowledge of quality improvement methods and tools. The factors that modulate motivation and assessment of skills in these projects are still unclear. The objective of this study was to analyze barriers and facilitators to the motivation of healthcare professionals to participate in a large collaborative quality improvement project, creating and validating a quality improvement competency assessment tool. Methods: the motivation study was qualitative, based on content analysis of semi-structured in-depth interviews with healthcare professionals participating in the collaborative quality improvement project “Improving patient safety on a large scale in Brazil” involving 116 Brazilian hospitals. We carried out interviews via videoconference with 28 health professionals who participated in the project, using the saturation principle. Data was coded using NVivo software and analysis was based on the Capability, Opportunity, Motivation and Behavior (COM-B) model and the Model for Understanding Success in Quality (MUSIQ). The skills assessment questionnaire was constructed after a literature review and the content analysis was carried out by a panel of experts using the Delphi technique. The skills assessment questionnaire contained 43 items, distributed across four domains, covering hard and soft skills, and demographic information. 14 experts participated in the first round and 12 experts in the second. All experts had more than 5 years of experience in quality improvement. Results: the barriers found were non-involvement of senior management, demand for immediate results, lack of inputs, excessive bureaucracy for changes, work overload, lack of scheduled workload for the project, resistance from experienced health professionals, belief in that improvement increases the workload, difficulty in engaging night shift professionals, little involvement of doctors, lack of knowledge about quality improvement and collection of indicators. Active participation of senior management in rounds, institutional policy of continuous improvement, quality improvement team present, enthusiasm of the team leader, understanding the reason for changes, teamwork, participating in change tests, learning in practice, celebrating small results and feedback on results were facilitators for motivation. The questionnaire was validated in two rounds with a minimum CVI of 83% and a maximum of 100%. Two items were eliminated. One for CVI below 80% and the other was redundant and was condensed into a single item. The final questionnaire had 41 items. Conclusion: this study reinforced the importance of customizing large projects, involving motivation modulators, intervening in the factors identified as barriers and facilitators. The skills assessment questionnaire closes the link between motivation and capacity for improvement, which are proximal contextual determinants of the microsystem necessary for the success of quality improvement projects.

COMMITTEE MEMBERS:
Presidente - 1868020 - ZENEWTON ANDRÉ DA SILVA GAMA
Interna - 1245215 - SEVERINA ALICE DA COSTA UCHOA
Externo ao Programa - 2171948 - PAULO JOSE DE MEDEIROS - UFRNExterna à Instituição - LAURA MARIA CÉSAR SCHIESARI - FGV
Externo à Instituição - MARGARETH CRISÓSTOMO PORTELA - ENSP