Key factors influencing the effectiveness of hospital quality management tools: using the quality control circle as an example-a cross-sectional study

Objective To identify the key factors influencing the effectiveness of hospital quality management tools and analyse the mechanisms needed for long-term scientific hospital management. Methods In this cross-sectional study, a large number of participants in quality control circle (QCC) activities were investigated on site. Data were collected by the questionnaire during the sixth National Hospital Quality Control Circle Competition in Shandong, China, in October 2018. A total of 1500 participants were randomly selected, in which 1316 questionnaires were completed, yielding an overall response rate of 87.73%, and 1181 questionnaires were valid. We performed a stepwise regression analysis to identify the independent variables with explanatory ability. Then the total mean score of the organisational, group, and individual factors were introduced layer by layer, and a regression model with four levels was established. Results The application effectiveness of QCC activities can be divided into three dimensions: individual factors, group factors and organisational factors. Utility perception was the most important individual factor. Inappropriate incentives and rewards had a negative effect on both organisational effectiveness and individual effectiveness. The attitude and ability of the circle monitor and counsellors, the specificity of the goals were the key group factors. Of the organisational factors, activity orientation had the greatest impact. Among the three dimensions, individual factors had the most significant influence on the effectiveness of QCCs, followed by group factors, then by organisational factors. Conclusion These results suggest that addressing the concerns of the leaders and implementing a safeguard system that protects the QCC tool from neglect or failure, that strengthening team building and using team rewards or non-material incentives to enhance enthusiasm, and that mobilising the enthusiasm of the circle members and even the whole hospital for using quality management tools are essential.