Factors associated with the successful implementation of a quality improvement project in human immunodeficiency virus ambulatory care clinics.

Academic Article


  • We examined a quality improvement (QI) program, offered to ambulatory care clinics (N = 82) serving human immunodeficiency virus-positive clients, to determine what factors predicted the clinic independently implementing QI processes without their program consultant's help. Initial analyses examined clinics at 4 levels of involvement: withdrew from the project, initial QI proficiency, advanced QI proficiency, and consultant independent. The initial and advanced stages were collapsed into 1 group (consultant dependent) and compared with consultant-independent clinics for multivariate logistic regression. In the multivariate models, 3 factors significantly predicted the clinic being consultant independent: staffing level (odds ratio [OR] = 1.6, 95% confidence interval [CI] = 1.2-2.2), the number of participating months (OR = 1.4, 95% CI = 1.0-2.0), and baseline QI readiness (OR = 1.1, 95% CI = 1.0-1.3). Receiver operator curves were calculated for significant predictors; the strongest predictor was staffing (c statistic = .79). Clinics that are organizationally prepared for QI, allow adequate time to adopt QI methods into their organization, and provide adequate QI staffing are more likely to independently apply QI methods.
  • Authors

  • Warner, Grace
  • Drainoni, Mari-Lynn
  • Parker, Victoria
  • Agins, Bruce D
  • Eldred, Lois
  • Status

    Publication Date

  • 2004
  • Published In


  • Ambulatory Care Facilities
  • Confidence Intervals
  • Data Collection
  • HIV Seropositivity
  • Humans
  • New York
  • Outcome and Process Assessment, Health Care
  • Quality Assurance, Health Care
  • Digital Object Identifier (doi)

    Pubmed Id

  • 15115278
  • Start Page

  • 75
  • End Page

  • 82
  • Volume

  • 19
  • Issue

  • 2