SHM Converge Scientific Abstract ePoster Gallery-Covid's Effect on the Implementation of a Multifaceted Intervention to Improve Teamwork and Quality for Hospitalized Patients

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This document summarizes a qualitative study on how COVID-19 affected the implementation of RESET, a multifaceted hospital quality improvement intervention aimed at improving teamwork and quality for hospitalized patients.<br /><br />The study was conducted across four hospitals and used semi-structured Zoom interviews with 40 participants, including nurses, physicians, case managers, site leaders, senior leaders, and others. Interview transcripts were coded in MAXQDA using inductive qualitative content analysis.<br /><br />Key findings showed that COVID created major new problems for hospitals. Early in the pandemic, patient volumes dropped, worsening financial strain, but later volumes increased and patients were sicker. Staffing became difficult because of pre-existing shortages and illness/exposure-related absences. COVID also changed communication, workflow, and workload.<br /><br />Participants described quality improvement, including RESET, as no longer being the priority during the crisis. Many staff and leaders focused on immediate survival, supporting frontline workers, and managing COVID-related changes. In some cases, COVID was even used as a reason to pause or abandon RESET activities.<br /><br />As a result, implementation fidelity regressed across all five RESET interventions: unit-based physician teams, nurse-physician co-leadership, enhanced interprofessional rounds, unit-level performance reports, and patient engagement activities. Some hospitals were able to restart efforts after the worst waves, but recovery was uneven.<br /><br />Despite these challenges, RESET had previously improved relationships, communication, and trust among team members and with patients. Participants expressed a sense of loss when those gains faded.<br /><br />Overall, the study concludes that major external disruptions like COVID can divert attention from quality improvement and weaken implementation. The authors suggest that future interventions should include strategies to better withstand similar disruptions.

Asset Subtitle

Iva Terwilliger

Meta Tag

Author List Iva Terwilliger, Julie K. Johnson, Kevin J. O'Leary, Mark v. Williams, Milisa Manojlovich

Category Research

Concept COVID-19 Pandemic

Concept Intervention Fidelity

Concept Resume

Concept Hospital Quality Improvement Intervention

Concept Staffing Shortage

Distinguished Non-Finalist

Presenter Organization Northwestern University

Presenting Author Iva Terwilliger

Track Quality Improvement

Keywords

COVID-19

hospital quality improvement

RESET intervention

implementation fidelity

teamwork

qualitative study

staffing shortages

interprofessional communication

patient engagement

pandemic disruption

COVID-19 Pandemic

Intervention Fidelity

Resume

Hospital Quality Improvement Intervention

Staffing Shortage