ArticlePloS one2024
A mixed-methods descriptive study on the role of continuous quality improvement in rural surgical and obstetrical stability: Considering enablers, challenges and impact.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Summative evaluation of the rural surgical obstetrical networks initiative: Findings from a five year retrospective qualitative study.PloS one · 2026Article
- 'I Am Not Going, So You're Doing It': Management of Pregnant People With High BMI at Rural Hospitals in British Columbia: A Mixed Methods Analysis.The Australian journal of rural health · 2025Article
- Examining Changes in Compassion Satisfaction, Burnout, Secondary Traumatic Stress and Work-Related Quality-of-Life of Rural Surgical and Obstetrical Nurses in British Columbia During the COVID-19 Pandemic.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2025Article
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Authors and funding
7 authors.
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Abstract
introductionThe Rural Surgical Obstetrical Networks (RSON) initiative in BC was developed to stabilize and grow low volume rural surgical and obstetrical services. One of the wrap-around supportive interventions was funding for Continuous Quality Improvement (CQI) initiatives, done through a local provider-driven lens. This paper reviews mixed-methods findings on providers' experiences with CQI and the implications for service stability.
backgroundSmall, rural hospitals face barriers in implementing quality improvement initiatives due primarily to lack of resource capacity and the need to prioritize clinical care when allocating limited health human resources. Given this, funding and resources for CQI were key enablers of the RSON initiative and seen as an essential part of a response to assuaging concerns of specialists at higher volume sites regarding quality in lower volume settings.
methodsData were derived from two datasets: in-depth, qualitative interviews with rural health care providers and administrators over the course of the RSON initiative and through a survey administered at RSON sites in 2023.
findingsQualitative findings revealed participants' perceptions of the value of CQI (including developing expanded skillsets and improved team function and culture), enablers (the organizational infrastructure for CQI projects), challenges in implementation (complications in protecting/prioritizing CQI time and difficulty with staff engagement) and the importance of local leadership. Survey findings showed high ratings for elements of team function that relate directly to CQI (team process and relationships).
conclusionAttention to effective mechanisms of CQI through a rural lens is essential to ensure that initiatives meet the contextual realities of low-volume sites. Instituting pathways for locally-driven quality improvement initiatives enhances team function at rural hospitals through creating opportunities for trust building and goal setting, improving communication and increasing individual and team-wide motivation to improve patient care.
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