Impact of quality strategies on hospital outputs

Abstract

Context: This study was part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project on patients crossing borders, a study to investigate quality improvement strategies in healthcare systems across the European Union (EU). Aim: To explore the association between the implementation of quality improvement strategies in hospitals and hospitals' success in meeting defined quality requirements that are considered intermediate outputs of the care process. Methods: Data regarding the implementation of seven quality improvement strategies (accreditation, organisational quality management programmes, audit and internal assessment of clinical standards, patient safety systems, clinical practice guidelines, performance indicators and systems for obtaining patients' views) and four dimensions of outputs (clinical, safety, patient-centredness and cross-border patient-centredness) were collected from 389 acute care hospitals in eight EU countries using a web-based questionnaire. In a second phase, 89 of these hospitals participated in an on-site audit by independent surveyors. Pearson correlation and linear regression models were used to explore associations and relations between quality improvement strategies and achievement of outputs. Results: Positive associations were found between six internal quality improvement strategies and hospital outputs. The quality improvement strategies could be reasonably subsumed under one latent index which explained about half of their variation. The analysis of outputs concluded that the outputs can also be considered part of a single construct. The findings indicate that the implementation of internal as well as external quality improvement strategies in hospitals has beneficial effects on the hospital outputs studied here. Conclusion: The implementation of internal quality improvement strategies as well as external assessment systems should be promoted.This study forms part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) project. The objectives of the MARQuIS project are to research and compare different quality improvement (QI) policies and strategies in healthcare systems across the member states of the European Union (EU), and to consider their potential value when patients cross borders to receive healthcare. This research was intended to enable an evaluation of the need for, and development of, formal quality procedures at the EU level for healthcare services.To identify quality strategies in Europe, quality policies were analysed, and a survey of key experts in QI from the 25 member states comprising the EU in 2005 was conducted to gather information about views and accounts of QI policies and strategies in their healthcare systems. Seven main strategies were identified 1 : c accreditation c organisational quality management programmes (TQMs) c audit and internal assessment of clinical standards (internal assessment) c patient safety systems (patient safety) c clinical practice guidelines (clinical ...

Análise de causa raiz de acidentes por quedas e erros de medicação em hospital

“…Latent failures remain "asleep" in this system and are related to organizational influences, unsafe supervision and predisposition to unsafe acts. (14) Another important aspect of the study was the finding that a great part of causal factors of falls was affected by the absence of protocol of fall prevention within the studied institution.…”

Akkreditáció az egészségügyben

“…Az akkreditációs rendszerek diverzifitása visszavezethető az országok eltérő erőforrásból gazdálkodó, eltérő szükségletekre tervezett egészségügyi rendszereinek különbözőségére [11,14]. Bár az akkreditáció eredmé-nyességének kutatása jelenleg is több kutatócsoport ér-deklődésének középpontjában áll, feltételezhetően a helyi sajátosságokhoz igazítottsága teszi képessé arra, hogy bizonyítottan szignifikáns mértékben javítsa az ellátás minőségét és a betegbiztonságot [15].…”

Why adopt ISO 9001 certification in hospitals? A case study of external triggers and sensemaking in an emergency department in Norway

“…Studies of 89 European hospitals indicate that accreditation and International Organization for Standardization (ISO) 9001 certification are positively associated with some quality and safety structures and hospital outputs such as hospital management, clinical practice, safety, patient-centeredness and cross-border patient-centeredness. These studies demonstrated that accreditation has slightly more impact than ISO certification, but either system is better than no external assessment [11,12]. The recent EU project DUQUE with data from 73 European hospitals studied the relationship between ISO 9000 certification, healthcare accreditation, and quality management.…”