The RCQ Model: Conceptualizing Inter-Clinician Relationships, Communities of Practice and Quality Improvement in Healthcare

The RCQ Model: Conceptualizing Inter-Clinician Relationships, Communities of Practice and Quality Improvement in Healthcare

Michael Dohan (McMaster University, Canada), Ted Xenodemetropoulos (McMaster University, Canada) and Joseph Tan (McMaster University, Canada)
DOI: 10.4018/jhisi.2012040103
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As society moves into the age of active knowledge management and sharing, inter-clinician relationships and communities of practice can be directed to support quality improvement efforts within healthcare organizations. It is argued that successful adoption of the processes that are critical to quality improvement is necessary for durable improvements in quality. Knowledge sharing is necessary for supporting the skills in performing activities associated with practice audit, change management and use of the associated technology. This paper introduces the Relationships, Communities, Quality (RCQ) model, which provides a framework for the purpose of conceptualizing how quality improvement in healthcare can be sustained. A variance model is proposed for the evaluation of communities of practice for their value in quality improvement in healthcare.
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Background–Quality Improvement In Healthcare

In Canada, clinicians, managers and policymakers are aware of quality deficiencies in the Canadian healthcare system, as it is a top priority of Health Canada (2004). Preventable adverse events (AEs), which are unintended injuries or complications resulting in harm of a patient, offer an example of this. It has been estimated that, of 185,000 acute care hospital admissions associated with AEs, 70,000 may have been preventable. Insufficient emergency room capacity and wait times for surgery have occasionally resulted in occasionally fatal consequences (“Ontario emergency room waits,” 2005; “Alta. MLA alleges hush-money,” 2011; Global Winnipeg, 2009). As well, factors including rapidly escalating medical costs and increasing demands for accountability and transparency in clinical practice, have mandated the development of metrics in performance assessment and mechanisms for promoting perpetual improvement in quality (Harrigan, 2000).

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