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Table 2 MUSIQ framework categories and contextual factors identified from our case

From: A qualitative study of contextual factors’ impact on measures to reduce surgery cancellations

MUSIQ framework categories Contextual factors identified from our case
External environment • Input from patients about quality problems
External motivators • Cancellation rate as a national quality indicator
• Circulating ideas on patient-centered care
Organization • An organizational improvement strategy that provided a foundation for the improvement work by emphasizing:
Quality improvement (QI) leadership
o Involvement of frontline clinicians
Maturity of organizational QI o Improvement by changing the clinical system
Culture supportive of QI  
Quality improvement • Guidance about improvement techniques and project support for the improvement teams
support and capacity
Data infrastructure • Expedient use of information technology
Resource availability
Microsystem • Communication with and involvement of clinicians outside the improvement teams
Quality improvement leadership
• Middle managers’ role in following up and securing context-sensitive implementation of interventions
Motivation to change
• Middle managers as role models participating in daily work
• The shared belief that change was needed among hospital employees
Quality improvement team • A meeting place for sharing information
Team diversity • Participation from all of the relevant professional groups in improvement teams, including physicians
Physicians’ involvement