Our Accomplishments

In 2011, HSSC completed a two-year study of rural practices in South Carolina, which focused on the organizational factors that lead to change and adoption of quality improvement (QI) activities. HSSC and its partners worked with 16 rural sites to complete the study. During the project, a QI coach and a data manager spent time at each site to identify and implement small changes that could lead to larger system changes and ultimately result in quality improvement.

“In the study, we learned a great deal about how organizational characteristics impact change adoption or rejection, and we were able to document and quantify improvements in several quality indicators,” explains Kevin Bennett, PhD, of the University of South Carolina, the study’s principal investigator. Bennett and Amy Brock Martin, DrPH, MSPH, who oversaw the project for HSSC, said the study possessed strong translational value, revealing major factors that influence change in medical practices:

1. Physician participation is key. Physician acceptance or rejection is often the deciding factor in whether a practice adopts QI activities.
2. Practices need a QI champion, a physician, nurse or administrative person, who will raise awareness internally.
3. Perception is important. Some see QI activities as an opportunity to improve healthcare delivery or patient outcomes, while others see them as burdensome. Those who perceive QI tasks as as burdensome made minimal changes or quickly abandoned the process.
4. Practices must see the need to change.
5. Intrinsic factors are more likely to drive change than external pressures.

The practical lessons learned through the study helped HSSC as it works with practices to adopt health care changes.The first study of its kind study provided practical information about what it takes to get providers to adopt new technologies and achieve meaningful use. The study was particularly valuable as South Carolina launched its statewide health information exchange (SCHIEx). Findings helped practices through the adoption curve of electronic medical records to improve healthcare quality.