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American Journal of Medical Quality
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Implementing Quality Improvement in Hospitals: The Role of Leadership and Culture

Victoria A. Parker, DBA

Management Decision and Research Center (152M), Health Services Research and Development Service, Veterans Health Administration, Boston, Mass and with the Health Services Department, Boston University School of Public Health, Boston, MA, Center for Health Quality Outcomes and Economic Research, Bedford, MA

William H. Wubbenhorst, MBA

Management Decision and Research Center (152M), Health Services Research and Development Service, Veterans Health Administration, Boston, Mass and with the Health Services Department, Boston University School of Public Health, Boston, MA

Gary J. Young, JD, PhD

Management Decision and Research Center (152M), Health Services Research and Development Service, Veterans Health Administration, Boston, Mass and with the Health Services Department, Boston University School of Public Health, Boston, MA

Kamal R. Desai, PhD

Management Decision and Research Center (152M), Health Services Research and Development Service, Veterans Health Administration, Boston, Mass and with the Health Services Department, Boston University School of Public Health, Boston, MA

Martin P. Charns, DBA

Management Decision and Research Center (152M), Health Services Research and Development Service, Veterans Health Administration, Boston, Mass and with the Health Services Department, Boston University School of Public Health, Boston, MA

Many advocates of quality improvement (QI) suggest that there is a link between an organization's leadership commitment and culture and its ability to implement a QI initiative. This paper reports empirical evidence from a study of QI implementation in Veterans Health Administration (VHA) hospitals that supports this hypothesized linkage. The findings suggest that the extent to which top management becomes directly involved in QI activities determines the degree of QI implementation. Additionally, study findings suggest that a culture emphasizing innovation and teamwork provides an important foundation for implementing a QI initiative. We discuss the implications of these findings for organizational leaders interested in implementing QI.

American Journal of Medical Quality, Vol. 14, No. 1, 64-69 (1999)
DOI: 10.1177/106286069901400109
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