Building the Case for Quality Improvement in the Health Care Industry

Abstract

Health care organizations are under intense pressure to improve the efficiency and effectiveness of care delivery and, increasingly, they are using quality improvement teams to identify and target projects to improve performance outcomes. This raises the question of what factors actually drive the performance of these projects in a health care environment. Using data from a survey of health care professionals acting as informants for 244 patient care, clinical-administrative, and nonclinical administrative quality improvement project types in 93 health care organizations, we focus on 2 factors--goal setting and quality training--as potential drivers of quality improvement project performance. We find that project-level goals and quality training have positive associations with process quality, while organizational-level goals have no impact. In addition, the relationship between project-level goals and process quality is stronger for patient care projects than for administrative projects. This indicates that the motivational and cognitive effects of goal setting are greater for projects that involve interactions with clinicians than for ones that involve interactions with other staff. Although project-level goal setting is beneficial for improving process quality overall, our findings suggest the importance of being especially attentive to goal setting for projects that impact direct patient care.

Measuring quality performance between public and private hospitals in Malaysia

“…To overcome these quality problems, the policy makers for the both public and private hospitals need to consider five essential aspects to improve the overall performance, such as developing and clarifying an understanding of the healthcare problems, fostering and sustaining a culture of change and patient safety, continuous monitoring of performance and reporting of findings to sustain the change, testing change strategies for better performance and involving key stakeholders of the healthcare organisation (Varkey et al, 2007). In addition, both health sectors can follow some guidelines to improve their quality performance, such as selecting quality projects which are strategically significant for the hospital, providing especial training to the doctors and nurses about the quality tools and applications of the healthcare systems, developing the skills to design and use measures of quality to identify the key performance indicators of the healthcare services, not neglecting those services which are doing little to address quality problems and ensuring quality projects working on complex subjects by following the steps of a structured team working process (Ovretveit, 2000;Field et al, 2014). Once quality performance has improved, the hospitals will be able to fulfil patient needs through better quality services.…”

Linking Electronic Medical Records Use to Physicians’ Performance: A Contextual Analysis

“…Furthermore, given the large variety of specialties in healthcare, such interactions often occur among professionals possessing differing world views or values. Finally, physicians can have a stronger professional than organizational identification (Dobrzykowski, Callaway, & Vonderembse, ) and often prefer autonomy to collaborative and collective approaches (Leape & Berwick, ; Boyer & Pronovost, ; Field et al., ).…”

“…Conversely, shared values reduce motivations for opportunistic behaviors and prescribe cooperative activities such as information sharing, which in turn enables healthcare delivery professionals to coordinate better and improve performance (Klein, Rai, & Straub, ; Patel, Azadegan, & Ellram, ). “Goals serve to focus attention and effort on the desired performance outcome and motivate people to work toward that outcome,” (Field et al., : p. 141). Furthermore, information sharing enhances physicians’ performance because it embodies coordination among them and hospital nurses/staff.…”

“…Regarding the latter, hospital performance is influenced to a great extent by the performance of the physicians practicing in the hospital (Ilie, Van Slyke, Parikh, & Courtney, ; Sinha & Kohnke, ). Although hospitals make available facilities and staff for patient diagnosis and treatment, autonomous physicians, who may have different financial incentives than the hospital, are the chief source of medical decision making affecting length of stay, resource utilization, and ultimately hospital performance (Field, Heineke, Langabeer, & DelliFraine, ; Fredendall, Craig, Fowler, & Damali, ).…”

Efficacy of quality improvement and patient safety workshops for students: a pilot study

“…A gap between theoretical frameworks of improvement science and their practical application is readily apparent [1,2]. Based on recent healthcare trends, the majority of published quality improvement and patient safety (QI/ PS) data continues to be centered on clinical outcomes and improvement of care processes [3][4][5]. Less data is readily available regarding QI/PS medical education, especially in undergraduate medical education.…”