Conceptualising centres of excellence: a scoping review of global evidence

Abstract

ObjectiveGlobally, interest in excellence has grown exponentially, with public and private institutions shifting their attention from meeting targets to achieving excellence. Centres of Excellence (CoEs) are standing at the forefront of healthcare, research and innovations responding to the world’s most complex problems. However, their potential is hindered by conceptual ambiguity. We conducted a global synthesis of the evidence to conceptualise CoEs.DesignScoping review, following Arksey and O’Malley’s framework and methodological enhancement by Levac et al and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.Data sourcesPubMed, Scopus, CINAHL, Google Scholar and the Google engine until 1 January 2021.EligibilityArticles that describe CoE as the main theme.ResultsThe search resulted in 52 161 potential publications, with 78 articles met the eligibility criteria. The 78 articles were from 33 countries, of which 35 were from the USA, 3 each from Nigeria, South Africa, Spain and India, and 2 each from Ethiopia, Canada, Russia, Colombia, Sweden, Greece and Peru. The rest 17 were from various countries. The articles involved six thematic areas—healthcare, education, research, industry, information technology and general concepts on CoE. The analysis documented success stories of using the brand ‘CoE’—an influential brand to stimulate best practices. We identified 12 essential foundations of CoE—specialised expertise; infrastructure; innovation; high-impact research; quality service; accreditation or standards; leadership; organisational structure; strategy; collaboration and partnership; sustainable funding or financial mechanisms; and entrepreneurship.ConclusionsCoEs have significant scientific, political, economic and social impacts. However, there are inconsistent use and self-designation of the brand without approval by an independent, external process of evaluation and with high ambiguity between ‘CoEs’ and the ordinary ‘institutions’ or ‘centres’. A comprehensive framework is needed to guide and inspire an institution as a CoE and to help government and funding institutions shape and oversee CoEs.

Criteria and Indicators for Centers of Clinical Excellence in Stroke Recovery and Rehabilitation: A Global Consensus Facilitated by ISRRA

“…The criteria and indicators were developed collaboratively and explicitly recognize that clinical excellence in stroke recovery and rehabilitation is likely to be a multi-faceted, emergent property of the systemic interactions between staff, people living with stroke, carers, industry partners, and organizational factors. Unlike previous work that has described excellence as a product, 4 our criteria clearly recognize that a culture that fosters and supports excellence is vital and that clinical excellence is likely to require an iterative process of continuous improvement. Use of the criteria and associated indicators provides a mechanism by which clinical excellence can be identified, described, and shared to generate global improvements in stroke care, organizational development and shape the culture required to deliver excellence.…”

“…Use of the criteria and associated indicators provides a mechanism by which clinical excellence can be identified, described, and shared to generate global improvements in stroke care, organizational development and shape the culture required to deliver excellence. 4 , 5 The criteria and indicators presented here have the potential to support organizations that aspire toward excellence to develop or refine their services, staff, and activities. Work is currently underway to user-test the criteria and indicators in 14 centers in 10 countries: Australia, Chile, China, Denmark, Ghana, India, Malaysia, Singapore, Sweden, and the UK.…”

“…In wider literature, centers of excellence are characterized by the use of innovative methods, a collaborative approach, and high-quality service 3 - 6 that produce exceptional outcomes and significant scientific, political, economic, or societal impacts. 4 It is widely agreed that CoCE should demonstrate expertise in a specific area to enable delivery of comprehensive interdisciplinary care that optimizes patients’ outcomes. 5 In stroke, many models, standards, and measures have been developed to reduce variability in care and demonstrate clinical effectiveness.…”

Requirements for Brazilian Outpatient Centers of Excellence in Hidradenitis Suppurativa: Consensus Co-Creative Study

“…17,18 Establishing centers of excellence is a complex milestone that involves the study of the delivery, organization, financing, and outcomes of healthcare services. [19][20][21] Conducting research in this field requires a deep understanding of the complex interplay between social, economic, and clinical factors that shape healthcare systems and the delivery of services. 19 Purposely, there is growing evidence to support the use of innovation, design, and co-creation techniques in healthcare services research.…”

“…[19][20][21] Conducting research in this field requires a deep understanding of the complex interplay between social, economic, and clinical factors that shape healthcare systems and the delivery of services. 19 Purposely, there is growing evidence to support the use of innovation, design, and co-creation techniques in healthcare services research. [22][23][24][25][26] This approach is useful considering that healthcare services are a complex and dynamic system that involves multiple stakeholders and that their input and involvement are crucial for creating services that are effective, efficient, and responsive to the needs of patients and communities.…”