Patient Safety and Quality

Leadership support and fair work distribution keep morale high during quality improvement initiatives

Quality improvement (QI) projects at health care settings usually benefit patients' health but can create burdens for staff charged with performing and documenting new tasks. A new study finds that centers that undertake QI initiatives can take steps to improve staff morale and reduce burnout. Researchers from the National Opinion Research Center, the University of Chicago, and the MidWest Clinicians' Network received surveys from 118 team leaders and 504 team members at 145 community health centers in the Midwest that were participating in the nationwide Health Disparities Collaboratives in 2004. The collaboratives aim to improve health outcomes for patients with chronic conditions, such as diabetes, asthma, depression, and cardiovascular disease. They do this by having staff attend regular education sessions, maintaining information systems, and monitoring patients' progress.

These additional QI duties can lead to staff burnout and turnover. Fewer than half of those who responded agreed that the centers had enough funding or staff to run the collaborative, and a third responded that the centers had not allocated paid time for staff to enter data, maintain the registry, and perform QI interventions.

However morale increased with sufficient staffing, leadership, and provider support, and fair task distribution. Staff member morale was also high when they believed the skills they developed during their work with the collaborative would lead to career promotion. The authors suggest that leaders who wish to undertake QI projects should structure tasks to stress how employees benefit by participating. This study was funded in part by the Agency for Healthcare Research and Quality (HS10479 and HS13635).

See "Predicting changes in staff morale and burnout at Community Health Centers participating in the Health Disparities Collaboratives," by Jessica E. Graber, Ph.D., Elbert S. Huang, M.D., M.P.H., Melinda L. Drum, Ph.D., and others in the August 2008 Health Services Research 43(4), pp. 1403-1423.

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