Role of Middle Managers in Quality Improvement Implementation

Abstract

Limited consensus exists around the manager’s role in QI project implementation as viewed by both managers and other stakeholders alike. The aim of this research is to investigate how middle managers in a Canadian critical care setting perceive their role and associated responsibilities in facilitating the implementation of a mandated QI project. Interviews with eight critical care middle managers were conducted to understand how they viewed their role during the implementation of a mandated delirium screening and management QI project. Using Charmaz’s (2014) approach to grounded theory, an explanatory framework is created demonstrating that managers perceive their role as ensuring or building multi-faceted understanding of the project amongst frontline staff members. Understanding assists in engaging staff during project implementation and helps to “make sense of the project”. Barriers managers experience include prioritizing QI projects amongst competing priorities, leading the multidisciplinary team, and supporting the local context with limited QI knowledge.