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Table 2 MUSIQ framework categories and contextual factors identified from our case

From: A qualitative study of contextual factors’ impact on measures to reduce surgery cancellations

MUSIQ framework categories

Contextual factors identified from our case

External environment

• Input from patients about quality problems

External motivators

• Cancellation rate as a national quality indicator

• Circulating ideas on patient-centered care

Organization

• An organizational improvement strategy that provided a foundation for the improvement work by emphasizing:

Quality improvement (QI) leadership

o Involvement of frontline clinicians

Maturity of organizational QI

o Improvement by changing the clinical system

Culture supportive of QI

 

Quality improvement

• Guidance about improvement techniques and project support for the improvement teams

support and capacity

Data infrastructure

• Expedient use of information technology

Resource availability

Microsystem

• Communication with and involvement of clinicians outside the improvement teams

Quality improvement leadership

• Middle managers’ role in following up and securing context-sensitive implementation of interventions

Motivation to change

• Middle managers as role models participating in daily work

• The shared belief that change was needed among hospital employees

Quality improvement team

• A meeting place for sharing information

Team diversity

• Participation from all of the relevant professional groups in improvement teams, including physicians

Physicians’ involvement