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Quality improvement designs are related to the degree of organisation of quality systems: an empirical study of hospital departments
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiolog)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. (Socialmedicinsk epidemiologi)
2007 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 84, no 2-3, 191-9 p.Article in journal (Refereed) Published
Abstract [en]

Quality systems can help departments do the right things and do things right, but organisation and design need to be considered. The aim was to analyse whether quality systems that include certain quality improvement designs differ with regard to organisational factors and degrees of organisation. A questionnaire was developed and sent to a random sample of 600 hospital departments in Sweden (response rate=75%). A k-means cluster analysis was used to group departments into three degrees of organisation. Analyses of variance were done to study differences in organisational factors and quality improvement designs among the clusters. LISREL analyses were done to study the relationships between organisational factors and quality improvement designs. The results showed that quality systems that included certain quality improvement designs differed with regard to the organisational factors available resources, administration, culture, cooperation, and goal achievement. The results also showed that departments with quality systems of different organisational degrees used different quality improvement designs. Some quality improvement designs may require a quality system with a high degree of organisation to support a successful implementation. The appended questionnaire could be used to plan implementations and evaluate their results.

Place, publisher, year, edition, pages
2007. Vol. 84, no 2-3, 191-9 p.
Keyword [en]
Quality system, quality improvements, health care organisation, model
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-96706DOI: 10.1016/j.healthpol.2007.04.007PubMedID: 17553588OAI: oai:DiVA.org:uu-96706DiVA: diva2:171367
Available from: 2008-02-08 Created: 2008-02-08 Last updated: 2017-12-14
In thesis
1. Quality Management in Hospital Departments: Empirical Studies of Organisational Models
Open this publication in new window or tab >>Quality Management in Hospital Departments: Empirical Studies of Organisational Models
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general aim of this thesis was to empirically explore the organisational characteristics of quality systems of hospital departments, to develop and empirically test models for the organisation and implementation of quality systems, and to discuss the clinical implications of the findings.

Data were collected from hospital departments through interviews (n=19) and a nation-wide survey (n=386). The interviews were analysed thematically and organisational models were developed. Relationships among aspects of organisation and implementation were hypothesised and analysed with structural equation modelling.

The result was a new framework with three organisational aspects of quality systems each with two sub-aspects: structure (resources and administration), process (culture and cooperation), and outcome (evaluation of goal achievement and development of competence).

Strong positive relationships were confirmed among structure, process, and outcome. Quality systems could therefore be classified into three organisational degrees. For instance, quality systems of high organisational degree often had adequate resources and administration as well as positive organisational cultures and high cooperation among different professions.

Advanced designs required quality systems of high organisational degrees. Examples of such designs were coordination between departments, random check ups, and accreditation.

The organisationally demanding quality systems had been implemented through cooperative implementation, that is, directed by managers while at the same time giving opportunities for staff to participate in planning and designing.

The results can be useful to managers, quality coordinators, and clinicians when they describe, develop, implement, and evaluate the effectiveness and efficiency of quality systems in hospital departments.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2008. 75 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 309
Keyword
Social medicine, Quality Management, Organisational Models, Hospital Departments, Socialmedicin
Identifiers
urn:nbn:se:uu:diva-8428 (URN)978-91-554-7082-1 (ISBN)
Public defence
2008-03-03, Rudbecksalen, Rudbecklaboratoriet, Dag Hammarskjölds väg 20, Uppsala, 13:15
Opponent
Supervisors
Available from: 2008-02-08 Created: 2008-02-08 Last updated: 2010-12-30Bibliographically approved

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Rosenqvist, UrbanWesterling, Ragnar

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