Contemporary quality improvement

Øvretveit, John

doi:10.1590/s0102-311x2013000300002

Cited by 11 publications

(8 citation statements)

References 3 publications

(2 reference statements)

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“…Finally, although this study examines the ‘engagement’ scores across two time points, it could be considerably strengthened with pre-intervention measures and additional data from further phases which would allow more complex analysis of relationships between employment grade, specialty site and the control group. It would also go some way to help address the growing concerns in regard to understanding the many influences involved in sustaining healthcare QI over time [ 1 , 53 , 54 ]. However, it is worth noting that QI programmes, interventions and activities by their very nature are action-orientated occurrences and do not naturally lend themselves to the criteria and standards of experimental design.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, poor perception and experiences of healthcare from both patients and the media have collectively combined to provide many of the ingredients for a ‘perfect storm’ in healthcare crisis terms. This has led to an international call-to-action to ‘rescue’ the provision of healthcare with a particular renewed focus on initiatives that improve the quality of healthcare [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The challenge for contemporary healthcare QI initiatives are how they ‘engage’ the many competing logics, interests and intentions to deliver improvements in the key areas of population health, patient experience and cost [ 1 , 18 ]. Productive Ward: Releasing Time to Care™ (PW) is one such QI programme that was designed to synergise the multiple aspects of QI and directly impact care provision, patient experience and costs [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Quality Improvement and ‘work engagement’; concluding results from a national, longitudinal, cross-sectional study of the ‘Productive Ward-Releasing Time to Care’ Programme

White

Butterworth

Wells

2017

BMC Health Serv Res

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BackgroundConcerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work; leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care.MethodsThe main objective of this study was to explore whether PW sustains the ‘engagement’ of ward-based teams by examining the longitudinal effect that the national QI programme had on the ‘work-engagement’ of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group.ResultsOverall findings demonstrated that those involved in the QI initiative had higher ‘engagement’ scores at T1 and T2 in comparison to the control group. Total ‘engagement’ score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006).ConclusionOur results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved in the QI programme are more likely to be ‘engaged’ by it and its associated improvement activities and that this is maintained over time. However, only the Vigour dimension of ‘engagement’ remained significantly higher in the PW over time.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2446-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Healthcare Quality Improvement and ‘work engagement’; concluding results from a national, longitudinal, cross-sectional study of the ‘Productive Ward-Releasing Time to Care’ Programme

White

Butterworth

Wells

2017

BMC Health Serv Res

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“…We have chosen to focus on hospital patient safety as an area of public policy that has grown in importance internationally as it has become known that around 10% of all patients are harmed during their hospital stay (Dolores Menéndez., et al, 2010;Asavaroengchai et al, 2009). In developed countries, a common response has been to implement national, or system-wide, programmes to improve patient safety that share similar elements (Øvretveit, 2013(Øvretveit, , Wachter et al, 2013Shekelle et al, 2013). Despite this homogeneity at the policy design stage, analysis of implementation reveals (but largely fails to explore) significant variations in terms of processes and outcomes (Ingold and Moghan, 2016;Rycroft-Malone et al, 2016;Stone, 2017;Nutley et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

The role of middle managers in the implementation of national public policy

Cooper

Kitchener

2019

Policy &Amp; Politics

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Recent policy implementation studies have considered the processes by which the top down objectives of policy designers conflict with the bottom up responses of local actors within functional teams. Our paper extends that body of research by analysing the, hitherto underexplored, role of hybrid middle managers (HMMs) who combine their professional expertise with management responsibilities to locally forge compromises when implementing national policy interventions. Drawing from a recent study of the implementation of the Welsh national patient safety programme, this paper presents a detailed analysis of the activities deployed by HMMs to broker policy interventions within their local teams. We provide an analytical model to direct attention towards the varied activities performed by HMMs from different occupations. Our empirical findings reveal how policy implementation processes can be better understood, and planned, if HMMs are differentiated by their occupational background.

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“…Em se tratando da qualidade ambiental associada a saúde humana, o termo é ampliado para as situações que tendem a comprometer as condições de vida dos envolvidos (FIGUEIREDO et al, 2010;OVRETVEIT, 2013). Desta forma, o risco ambiental vincula-se a qualidade de vida, pela caracterização dos fatores de risco que podem comprometer a saúde humana (SILVA et al, 2010).…”

Section: Introductionunclassified

Avaliação De Risco Ambiental Da Comercialização Do Pescado Na Região Portuária De Manaus/Amazonas

Cunha

Lima

Souza

et al. 2015

Ra'e Ga

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ResumoA segurança alimentar é uma preocupação recorrente, pois trata-se da necessidade de ingestão de alimentos que tenham um padrão de qualidade aceitável, sem risco à saúde. Neste trabalho, avaliam-se as condições de risco ambiental, associadas a uma área de livre comércio de pescado situada em uma região portuária localizada na Zona Sul de Manaus-AM, com 150 m de extensão, entre os igarapés do Educandos e São Raimundo, próxima a importantes locais comerciais; e as condições sanitárias do pescado durante sua comercialização, acondicionamento e descarte. No processo de análise foram consideradas as condições sanitárias do ambiente e do manipulador do alimento. O método utilizado foi a Análise de Falhas, Modos e Efeitos (FMEA). Os resultados demonstram que a aplicação do FMEA para

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Contemporary quality improvement

Cited by 11 publications

References 3 publications

Healthcare Quality Improvement and ‘work engagement’; concluding results from a national, longitudinal, cross-sectional study of the ‘Productive Ward-Releasing Time to Care’ Programme

Healthcare Quality Improvement and ‘work engagement’; concluding results from a national, longitudinal, cross-sectional study of the ‘Productive Ward-Releasing Time to Care’ Programme

The role of middle managers in the implementation of national public policy

Avaliação De Risco Ambiental Da Comercialização Do Pescado Na Região Portuária De Manaus/Amazonas

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