Sustainability of quality improvement teams in selected regional referral hospitals in Tanzania

OBJECTIVE: The aim of this study was to determine the sustainability of hospital quality improvement teams and to assess factors influencing their sustainability in the regional referral hospital in Tanzania. DESIGN: A cross-sectional study was conducted between April and August of 2018. SETTING AND PARTICIPANTS: The study was conducted in four selected regional referral hospitals in Tanzania. All members of the quality improvement teams available during the study period were recruited. INTERVENTION: Quality improvement teams and their activities. MAIN OUTCOME MEASURE: The primary outcome was sustainability total scores. The secondary outcomes were process, staff and organizational sustainability scores. The sustainability of quality improvement teams was assessed by using the National Health Service Institute for Innovation and Improvement Sustainability Model self-assessment tool. RESULTS: The overall mean sustainability score was 59.08 (95% CI: 53.69–64.46). Tanga Regional Referral Hospital had the highest mean sustainability score of 66.15 (95% CI: 55.12–77.18). Mbeya Regional Referral Hospital obtained the lowest mean sustainability score of 52.49 (95% CI: 42.96–62.01). The process domain had the highest proportionate mean sustainability score of 22.46 (95% CI: 20.58–24.33) across four hospitals. The staff domain recorded the lowest proportionate sustainability score of 27.28 (95% CI: 24.76–29.80). CONCLUSIONS: Perceived less involvement of senior leadership (hospital management teams) and clinical leadership (heads of clinical departments) and infrastructure limitation appeared to negatively affect the sustainability of the hospital quality improvement teams. Our study underscores the importance of establishing a permanent and fully resourced Quality Improvement Unit—with team members employed as full-time staff.