The drivers and impediments of implementing the quality improvement programmes at a government hospital in Eswatini: The registered nurses' perspective

Abstract

Implementation of quality improvement programmes in health care institutions is considered a priority for health institutions in improving the quality and safety of health care. The implementation of the programmes require efforts from all levels of staff and may be influenced by factors at an individual and organisational level. The purpose of this study was to describe and explore the drivers and impediments of the implementation of quality improvement programmes at a government hospital in Eswatini. A qualitative research design was used to explore and describe the drivers and impediments of implementing quality improvement programmes at a government hospital in Eswatini. Non-probability, purposive sampling was used to select the sample. Data were collected using face-to-face semi-structured interviews. Data analysis was conducted following Tesch’s method. The study identified human-related drivers as staff commitment and being appreciated and acknowledged. The organisational drivers were buy-in from management, capacity building, and a Multidisciplinary team approach, collaborations and partnerships. The human-related impediments were lack of ownership, resistance to change and lack of motivation. In contrast, organisational impediments were the absence of a clear implementation strategy, lack of leadership and management skills, lack of resources, poor reporting system and challenges from the government. Some significant drivers could be reinforced and challenges need to be addressed to facilitate the implementation of the programmes. Some of the human drivers and impediments were influenced by organisational drivers and impediments. Therefore, reinforcing organisational drivers and correcting impediments could be fundamental in enhancing the implementation of QIPs in the hospital.