Assessment of an intervention to train teaching hospital care providers in quality management.

BACKGROUND Successful implementation of continuous quality improvement (CQI) programs in hospitals remains rare in all countries, making it necessary to experiment with implementation methods while considering the cultural factors of resistance to change. OBJECTIVE To assess the impact of an educational intervention on involvement of clinical department staff in the quality process. SETTING Twelve voluntary clinical departments (six experimental and six controls) in a French 2000-bed university hospital comprising 40 clinical departments. INTERVENTION Three day training seminar to a group of 12-20 staff members from each department. DESIGN Quasi-experimental post-test only design study with control group conducted 12 months after the intervention with a questionnaire completed in a face-to-face interview. SUBJECTS 98 trained staff and 100 untrained staff from the six experimental departments and 100 staff from the six control departments. PRINCIPAL MEASUREMENTS Declared knowledge of the CQI methods and participation in quality management activities. RESULTS 286 people (96%) were involved in the study. More of the trained staff knew the CQI methods (62.4%) than staff in the control departments (16.5%) (adjusted odds ratio (ORa) = 10.6 (95% CI 4.97 to 22.62)). More trained staff also participated in quality improvement work groups than control department staff (76.3% v 14.0%; ORa = 27.4 (95% CI 11.6 to 64.4)). In the experimental departments the untrained staff's knowledge of CQI methods and their participation in work groups did not differ from that of control department staff. CONCLUSIONS A continuing education intervention can involve care providers in CQI. Dissemination of knowledge from trained personnel to other staff members remains limited.