What influences participation in QI? A randomized trial of addiction treatment organizations

Kyle L. Grazier, Andrew R. Quanbeck, John Oruongo, James Robinson, James H. Ford, Dennis McCarty, Alice Pulvermacher, Roberta A. Johnson, David H. Gustafson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Healthcare providers have increased the use of quality improvement (QI) techniques, but organizational variables that affect QI uptake and implementation warrant further exploration. This study investigates organizational characteristics associated with clinics that enroll and participate over time in QI. The Network for the Improvement of Addiction Treatment (NIATx) conducted a large cluster-randomized trial of outpatient addiction treatment clinics, called NIATx 200, which randomized clinics to one of four QI implementation strategies: (1) interest circle calls, (2) coaching, (3) learning sessions, and (4) the combination of all three components. Data on organizational culture and structure were collected before, after randomization, and during the 18-month intervention. Using univariate descriptive analyses and regression techniques, the study identified two significant differences between clinics that enrolled in the QI study (n = 201) versus those that did not (n = 447). Larger programs were more likely to enroll and clinics serving more African Americans were less likely to enroll. Once enrolled, higher rates of QI participation were associated with clinics' not having a hospital affiliation, being privately owned, and having staff who perceived management support for QI. The study discusses lessons for the field and future research needs.

Original languageEnglish (US)
Pages (from-to)342-353
Number of pages12
JournalJournal for Healthcare Quality
Issue number6
StatePublished - 2015


  • Characteristics
  • Organizational
  • Organizational culture
  • Process improvement
  • QI
  • Randomized trial

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'What influences participation in QI? A randomized trial of addiction treatment organizations'. Together they form a unique fingerprint.

Cite this