QI in organizational work groups ICA ‘04
24
The results of this study have implications for quality improvement in organizations, at least for
public sector organizations. While this study began as an attempt to better understand a theoretical
model that had been tested in a prior study with mixed results (cite omitted for this review), it became
clear to us once we got involved in the organization that the sensitive nature of the work, the
perspective of the employees, many of them front-line case workers, and the bureaucratic structure of
the agency contributed to the findings of this study. A previous study using this model (cite omitted
for review) in a health care organization found task variability to be a key predictor of quality
improvement measures, this study, conducted in a different setting, found task and unit
interdependence to be important predictors of attitudinal and behavioral dimensions of quality
improvement. What was it about this organization that can explain our findings? Comments from
employees from the survey and interviews reveal certain factors, untapped in the survey portion of this
study that seem to center around three key themes: a) trust and feedback; b) burnout (including
workload and time; and c) turnover.
One employee indicated that nothing happened as a result of QI - “If I felt that quality improvement
projects would be valued I would willingly participate, but my overall experience, especially with CQI,
is that my concerns and questions don't matter or lead to change.” Another decried the lack of
feedback, “The problem with CQI is we bring issues up but we hardly ever hear back.” But a big
theme was that of trust. When asked how a specific quality improvement program had been received,
one manager discussed issues of trust and double standards.
They really hated (specific program). I mean they really hated it. As they were going through it
in training, it was fun and many teams loved it. But when they did not see management using the
(specific program) principles then they started to dislike it. Initially, many of them thought it was
a good idea and now those same people will kill you over (specific program) because they are not
seeing it being practiced. They are very angry and they are very hateful over this. … There is the
perception of hypocrisy. Many people think that they (management) act like they care about us
when in fact they do not.
Another issue is burnout (including workload and time), and when asked if employee burnout is
related to willingness to engage in QI, One manager laughed and said
Convention