Implementing quality improvement in hospitals: The role of leadership and culture

Many advocates of quality improvement (QI) suggest that there is a link bet ween an organization's leadership commitment and culture and its ability to implement a QI initiative. This paper reports empirical evidence from a st udy of QI implementation in Veterans Health Administration (VHA) hospitals that supports this hypothesized linkage. The findings suggest that the exte nt to which top management becomes directly involved in QI activities de te rmines the degree of QI implementation. Additionally, study findings sugges t that a culture emphasizing innovation and teamwork provides an important foundation for implementing a QI initiative. We discuss the implications of these findings for organizational leaders interested in implementing QI.