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Study Examines Factors Associated with VA Employee Participation in Quality Improvement Program to Reduce Patient Wait Times


Healthcare organizations continually strive to implement new programs designed to improve patient care, including reducing the time patients must wait to see a clinician. Because VA has experienced a surge in its patient population, reducing wait times for healthcare is a priority. This study examined how employee attitudes, perceived group norms (e.g., social expectations), and perceived behavioral control (e.g., perceived ease or difficulty of performing a behavior) predict participation in a new clinic program designed to improve clinic operations and reduce patient waiting times. The program, Advanced Clinic Access (ACA), is a patient-centered approach that allows veterans to determine when they want to be seen by a clinician. Investigators analyzed data from a survey of employees (e.g., physicians, nurses, program support assistants) working in outpatient care in 78 VA medical centers. The survey focused on the ACA program and included questions about participation in the implementation and spread of the program, and how ACA impacted their work as well as patient care.

Findings suggest that perceived group norms and attitudes were related to greater individual participation in the ACA program, but perceived behavioral control was not found to be significant to participation. Overall, survey respondents typically engaged in just under half of the change behaviors. Regarding individual characteristics, employees with greater responsibility (e.g., nurse practitioners, RNs, and physicians) participated in more activities compared to other clinic employees. Team size, academic affiliation, and job satisfaction were not significant predictors of participation.

PubMed Logo Mohr D, VanDeusen Lukas C, and Meterko M. Predicting healthcare employees’ participation in an office redesign program: Attitudes, norms, and behavioral control. Implementation Science November 2, 2008;3(1):47

This study was funded by HSR&D. All authors are part of the HSR&D Center for Organization, Leadership and Management Research, Boston, MA.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.