The Relationship between Social Capital and Quality Management Systems in European Hospitals: A Quantitative Study

Abstract

BackgroundStrategic leadership is an important organizational capability and is essential for quality improvement in hospital settings. Furthermore, the quality of leadership depends crucially on a common set of shared values and mutual trust between hospital management board members. According to the concept of social capital, these are essential requirements for successful cooperation and coordination within groups. ObjectivesWe assume that social capital within hospital management boards is an important factor in the development of effective organizational systems for overseeing health care quality. We hypothesized that the degree of social capital within the hospital management board is associated with the effectiveness and maturity of the quality management system in European hospitals.MethodsWe used a mixed-method approach to data collection and measurement in 188 hospitals in 7 European countries. For this analysis, we used responses from hospital managers. To test our hypothesis, we conducted a multilevel linear regression analysis of the association between social capital and the quality management system score at the hospital level, controlling for hospital ownership, teaching status, number of beds, number of board members, organizational culture, and country clustering. ResultsThe average social capital score within a hospital management board was 3.3 (standard deviation: 0.5; range: 1-4) and the average hospital score for the quality management index was 19.2 (standard deviation: 4.5; range: 0-27). Higher social capital was associated with higher quality management system scores (regression coefficient: 1.41; standard error: 0.64, p=0.029). ConclusionThe results suggest that a higher degree of social capital exists in hospitals that exhibit higher maturity in their quality management systems. Although uncontrolled confounding and reverse causation cannot be completely ruled out, our new findings, along with the results of previous research, could have important implications for the work of hospital managers and the design and evaluation of hospital quality management systems.

Combining Direct and Indirect Measurements to Assess Patients’ Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

“…Social capital can be regarded as a property of an individual providing access to different resources [27], or Putnam's five-dimensions perspective [28,29], or a group perspective [30]. Regardless of its conceptualization, social capital is responsible for the perception of quality in health services [31].…”

Clinical Leadership and the Changing Governance of Public Hospitals: Implications for Patient Experience

“…However, here too, a small number of studies point to an association between greater clinical participation at this level and performance outcomes. For example, looking at seven countries (the Czech Republic, France, Germany, Poland, Portugal, Spain, and Turkey), Hammer et al () show that the quality of leadership, comprising clinical involvement on hospital boards, is significantly associated with a greater maturity of quality management systems. A study of NHS acute hospitals in England by Veronesi et al () also finds that a greater ratio of clinical members on governing boards generates better quality ratings.…”

Measuring social capital of healthcare organizations reported by employees for creating positive workplaces - validation of the SOCAPO-E instrument

“…The SOCAPO-E scale from then on has been used in a variety of studies within the healthcare sector including hospitals, cancer centers, hospital boards, nurses and private practices. In these studies, social capital in healthcare organizations was associated with diverse indicators and outcomes, such as job satisfaction [24], burnout [23,25], quality and risk management [15][16][17], perceived quality of care [19,20] and turnover [22]. Although face validity was proven by cognitive pretesting and content validity appears to be given by the items' representation of the six elements of community by Bauman, the instrument has never been completely validated beyond exploratory factor analysis.…”

“…This is only possible with the present large dataset of employees in 49 hospitals with a good response rate. Although the results are representative specifically for breast cancer care in the German state of North Rhine-Westphalia, the SOCAPO-E instrument has already been successfully applied in many different healthcare settings including hospital boards [11,15], wards [19,23] as well as private practices [22] in Germany and internationally [20,46,47]. Thus, the applicability to different types of healthcare organizations outside of breast cancer care can be assumed.…”

“…Especially, it fosters coordination and collective action [14]. Studies show that in healthcare organizations social capital fosters for example, quality and risk management [15][16][17] and quality of care [18][19][20]. A second function of social capital is to improve well-being and satisfaction at work, to create a sense of shared identity and belonging and thus diminish staff turnover and early retirement, also shown in healthcare organizations [13,[21][22][23][24][25].…”