Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Education


Educational Administration

Major Professor

E. Grady Bogue

Committee Members

Jeff Aper, Norma Mertz, Robert Pursley


The purpose of this study was to explore how implementation of the plan for performance improvement, the performance improvement program as required in the performance improvement standards of the Joint Commission on Accreditation of Healthcare Organizations, affected a particular acute care setting as perceived through multiple data sources. The purpose of this study was further explicated through the following four initial research questions: (1) Who are the participants in the performance improvement program? (2) How do members of the health care team at this particular acute care facility perceive the effect of the performance improvement program? (3) How does the performance improvement program affect the operation of this particular acute care facility? and (4) What is the decision utility of the various performance improvement data?

The design for this study was a case study consisting of the review of documents, collection of artifacts, interviews, observations of the environment, field notes, and a reflective/analytic journal. Data collection continued over a period of six months. Observations of the environment were initially recorded via handwritten notes and then transcribed into a typed format. Open ended questions were prepared prior to each interview and each interview then proceeded to explore in more depth the interviewee's responses to the guiding questions. In addition, several documents and artifacts were reviewed, which included various policies and procedures, written plans, committee minutes and reports.

This study was descriptive in nature beginning with an overview of the performance improvement program and its evolutionThe findings included the nine themes emerging from interviews as to the perceived effect of the performance improvement program; the seven ways the performance improvement program affected this particular acute care facility; and the use of the data collected by this facility as part of the performance improvement program, which included to facilitate decision making, to serve as an incentive, and to provide information.

This study was limited in scope as it explored the effect of the development and implementation of a performance improvement program at one particular acute care setting; however, the findings from this study may provide a foundation for future research.

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