Table 1

Contextual factors included in the Model for Understanding Success in Quality (MUSIQ)

Contextual factorInitial definition sourceFinal definition
External environment
 External motivatorsEnvironmental pressures and incentives that stimulate the organisation to improve its performance and quality in the area of focus of this QI project
 Project sponsorshipSubstantial and meaningful contributions of personnel, expertise, money, equipment, facilities, or other important resources from outside entities (external to the organisation) with formal relationships with this QI project
 QI leadership19 20Senior management's (CEO, COO, CMO, Senior VP, Board of Directors) governance—guidance, support, oversight, and direction setting—of improvement efforts
 Senior leader project sponsorSenior leader commitment to champion and support this QI project
 Culture supportive of QI21Values, beliefs, and norms of an organisation that shape the behaviours of staff in pursuing QI
 Maturity of organisational QISophistication of the organisation's QI programme
 Physician payment structurePhysicians are employed and compensated by the organisation
QI support and capacity
 Data infrastructure19Extent to which a system exists to collect, manage, and facilitate the use of data needed to support performance improvement
 Resource availability19Degree to which financial support for QI, including allocation of resources and staff time, is provided
 Workforce focus on QI19 22Degree to which the organisation develops the workforce through training and engages them in QI through reward systems and expectation setting
 QI leadership19Microsystem leadership capacity for improvement and degree to which they are personally involved in supporting and facilitating improvement efforts
 Culture supportive of QI21Values, beliefs, and norms present in the microsystem that emphasise teamwork, communication, freedom to make decisions, and commitment to improve
 Capability for improvementMicrosystem staff's ability to use QI methods for change
 Motivation to change23Extent to which microsystem staff members have a desire and willingness to improve performance in this area of focus
QI team
 Team diversityDiversity of team members with respect to professional discipline, personality, motivation, and perspective
 Physician involvement24Contribution of physicians to the QI team efforts
 Subject matter expertOne or more team members is knowledgeable about the outcome, process, or system being changed
 Team tenure25Team members have worked together as a team before
 Prior QI experience25Prior experience with QI
 Team leadership25 26Team leader's ability to accomplish the goals of the improvement project through guiding the actions of the QI team
 Team decision-making process27Team engages in well designed decision-making practices
 Team norms26 27Team establishes strong norms of behaviour related to how work is to be carried out and how goals are to be achieved
 Team QI skill28Team's ability to use improvement methods to make changes
 Trigger29Presence of a specific event (positive or negative) that stimulates a new emphasis on improving quality in the area of focus of a given QI project
 Task strategic importance to the organisation25Work perceived as part of the organisation's strategic goals
  • CEO, chief executive officer; CMO, chief marketing officer; COO, chief operating officer; QI, quality improvement; VP, vice president.