Relationships between internal facilitation processes and implementation outcomes among hospitals participating in a quality improvement collaborative to reduce cesarean births: a mixed-methods embedded case study

Abstract

Quality improvement collaboratives (QICs) are a common strategy for implementing evidence-based practices; however, there is often variable performance between participating organizations. Few studies of QICs assess the internal facilitation (IF) processes engaged in by participating organizations, which may be key to understanding and enhancing the effectiveness of QICs as an implementation strategy. We examined IF processes among hospitals participating in Maryland’s perinatal QIC to implement national guidelines for reducing primary cesarean births.