Transformational Performance Improvement: Why is Progress Slow?

August 24, 2023

In this article, the authors identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in healthcare organizations. They also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews of available literature. They discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves using conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, they discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real-world practice settings. Read the full article here.