Evaluating the impact of accreditation and external peer review

2015 ◽  
Vol 28 (8) ◽  
pp. 757-777 ◽  
Author(s):  
Melvin Kilsdonk ◽  
Sabine Siesling ◽  
Renee Otter ◽  
Wim van Harten
Keyword(s):  
Quality Of Care ◽  
Peer Review ◽  
Theoretical Framework ◽  
Control Group ◽  
Original Research ◽  
Content Type ◽  
Research Framework ◽  
Methodological Research ◽  
The Impact

Purpose – Accreditation and external peer review play important roles in assessing and improving healthcare quality worldwide. Evidence on the impact on the quality of care remains indecisive because of programme features and methodological research challenges. The purpose of this paper is to create a general methodological research framework to design future studies in this field. Design/methodology/approach – A literature search on effects of external peer review and accreditation was conducted using PubMed/Medline, Embase and Web of Science. Three researchers independently screened the studies. Only original research papers that studied the impact on the quality of care were included. Studies were evaluated by their objectives and outcomes, study size and analysis entity (hospitals vs patients), theoretical framework, focus of the studied programme, heterogeneity of the study population and presence of a control group. Findings – After careful selection 50 articles were included out of an initial 2,025 retrieved references. Analysis showed a wide variation in methodological characteristics. Most studies are performed cross-sectionally and results are not linked to the programme by a theoretical framework. Originality/value – Based on the methodological characteristics of previous studies the authors propose a general research framework. This framework is intended to support the design of future research to evaluate the effects of accreditation and external peer review on the quality of care.

Perceptions of nurses on the impact of accreditation on quality of care

2014 ◽  
Vol 19 (2) ◽  
pp. 69-82 ◽  
Author(s):  
Ahmet Yildiz ◽  
Sidika Kaya
Keyword(s):  
Regression Analysis ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Positive Impact ◽  
Pearson Correlation ◽  
High Rate ◽  
Content Type ◽  
Independent Variables ◽  
The Impact

Purpose – This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results. Design/methodology/approach – This study was performed as a cross-sectional, questionnaire-based survey on 258 nurses who started working in the hospital before it was accredited and continued to work during and after accrediation and who therefore knew both the hospital's pre-accrediation and post-accreditation periods. In this study, descriptive statistical analyses (means and standard deviations) were carried out to explore the views of the participants on “quality results,” “benefits of accreditation” and “participation of employees.” “Quality results” was considered to be the dependent variable, while “benefits of accreditation” and “participation of employees” were accepted as the independent variables. The relationship between the dependent variable and the independent variables was tested using Pearson correlation and multiple regression analysis. External patient satisfaction data collected by the quality department of the hospital before and after accreditation were also investigated. Findings – It was found that nurses had generally high scores for the items concerning the benefits of accreditation. There was a statistically significant positive correlation between the dependent variable (quality results) and the independent variables (benefits of accreditation and participation of employees). Regression analysis indicated that R2=0.461 and the extent to which the independent variables explained the dependent variable was 46.1 per cent, which is a high rate. Patient satisfaction scores increased after accreditation. Practical implications – Our study suggest that providing support for nurses, especially nurses with administrative responsibilities and incorporating employees into the process are important for exercising quality standards. Originality/value – Hospital accreditation has a positive impact on quality results especially on quality of care provided to patients and patient satisfaction. Study findings could guide policy makers and hospital managers in Turkey and in other countries who are preparing or implementing accreditation.

The impact of leadership churn on quality management in Australian hospitals

2019 ◽  
Vol 33 (7/8) ◽  
pp. 809-820
Author(s):  
Sandra Leggat ◽  
Cathy Balding
Keyword(s):  
Quality Of Care ◽  
Quality Management ◽  
Quality Indicators ◽  
Health Sector ◽  
Quality System ◽  
Board Members ◽  
Governing Board ◽  
Content Type ◽  
The Impact

Purpose The purpose of this paper is to explore the relationship between frequent turnover (churn) of the chief executive officer (CEO), quality manager and members of the governing board with the management of quality in eight Australian hospitals. Design/methodology/approach A mixed method three-year longitudinal study was conducted using validated quality system scales, quality indicators and focus groups involving over 800 board members, managers and clinical staff. Findings There were unexpected high levels of both governance and management churn over the three years. Churn among CEOs and quality managers was negatively associated with compliance in aspects of the quality system used to plan, monitor and improve quality of care. There was no relationship with the quality of care indicators. Staff identified lack of vision and changing priorities with high levels of churn, which they described as confusing and demotivating. There was no relationship with quality processes or quality indicators detected for churn among governing board members. Practical implications Governing boards must recognise the risks associated with management change and minimise these risks with robust clinical governance processes. Originality/value This research is the first that we are aware of that identifies the impact of frequent leadership turnover in the health sector on quality management.

Manager traits and quality-of-care performance in hospitals

2015 ◽  
Vol 28 (3) ◽  
pp. 200-215 ◽  
Author(s):  
Kjeld Harald Aij ◽  
René L.M.C. Aernoudts ◽  
Gepke Joosten
Keyword(s):  
Quality Of Care ◽  
Organizational Performance ◽  
Chief Executive Officers ◽  
Chief Executive ◽  
Content Type ◽  
Lean Transformation ◽  
Executive Officers ◽  
The Impact ◽  
Care Performance

Purpose – This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance. Design/methodology/approach – Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared. Findings – Four traits were found to be significantly different (alpha < 0.05) between lean (intermediate-) and low-performing hospitals. The different perceptions between these two hospital groups were all held by followers in the low-performing hospitals and not the CEOs, and all had a modern management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals. Originality/value – These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.

Patient portals and quality of care: A literature review using the BC Health Quality Matrix (Preprint)

2020 ◽  
Author(s):  
Alanna Black ◽  
Cathy Le ◽  
Jeffrey Barnett ◽  
Wan-Yun Tsai ◽  
Shawn Sangha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Literature Review ◽  
Public Healthcare ◽  
Original Research ◽  
Patient Access ◽  
Patient Portals ◽  
Health Records ◽  
University Of British Columbia ◽  
The Impact

BACKGROUND Electronic patient portals in healthcare are quickly becoming the preference of clinicians, patients, and caregivers alike. In times where the demand for all things to be online appears limitless, it is no surprise that portals are requested when updating health information systems worldwide. However, there are barriers to implementing online portals and many countries are lagging behind in updating their systems. With the interest in increasing investment in online portals by the Canadian public healthcare system, decision makers should be considering whether patient access to medical records through portals and mobile devices provides any changes to quality of care. OBJECTIVE This literature review examines available research in Canada and globally on health-related online portals and their impact on quality of care and patient access. Also examined are examples of different health portals, including issues or barriers to full implementation and utilization in the health sphere. METHODS A preliminary search was completed in May 2019 to examine the impact of patient portals on quality of care. The resources utilized in the first stage of the review included the University of British Columbia and the Western University library databases, Google, and Google Scholar. Parameters for the search included search terms such as patient portals, personal health records, effectiveness, quality, and access. Recent articles were prioritized, and included articles were generally published in the last five years. The authors reviewed 52 articles or article abstracts and 29 were included in the current review. Of the mixture of Canadian and international references, five are systematic reviews, and 18 are original research studies. RESULTS This study reviewed the available literature and found that there are some positive trends on patient portals’ impact on quality of care, with overall inconclusive or neutral results. Emerging evidence has showcased some benefits of implementing electronic health and patient portals to improve the quality of patient care and access to pertinent health records. However, general consensus is that there is limited available literature that is not considered to be outdated and as such, further investigation is required to support any previous findings. CONCLUSIONS As health care related technology develops further, better quality, quantity, and larger-scale studies will be available in evidence-based research databases. As such, a future follow-up literature review would be relevant to re-examine this topic.

A theoretical framework for managing intellectual capital in higher education

2019 ◽  
Vol 33 (5) ◽  
pp. 919-938 ◽  
Author(s):  
Giuseppina Iacoviello ◽  
Elena Bruno ◽  
Antonella Cappiello
Keyword(s):  
Higher Education ◽  
Intellectual Capital ◽  
Education Institution ◽  
Theoretical Framework ◽  
Content Type ◽  
Quality Of Higher Education ◽  
Pilot Model ◽  
The University ◽  
The Impact

Purpose The purpose of this paper is to identify, through the preparation of a theoretical framework, the drivers able to highlight the relationships between universities and stakeholders in the area of higher education. It also intends to stress the importance of intellectual capital (IC) regarding its contribution to create the quality of higher education. Design/methodology/approach The method, through the repetition of different “rounds” of interviews with questionnaires, tends therefore to create situations of comparison, verification and discussion of the different hypotheses prefigured, and then come to a convergence of both scenarios and dates of realization. Findings The paper provides a system of indicators for assessing the quality of relationships between stakeholders in the key processes of the universities. Research limitations/implications The paper provides a pilot model that needs further adjustments in itinere, based on rigorous empirical tests conducted to confer on it the characteristics of universal applicability within the university context. Practical implications The major contribution of the model is evident from the resulting interpretative process, which makes it possible to deduce, from the performance indicators, the strategies put in place by the university to achieve their goals, that is, to prepare any interventions for the optimization of the management of IC which can create the quality of higher education institution. Originality/value None of the models presented in the literature details the quality of the relationship between stakeholders in the key processes of the universities and therefore neither investigates the impact produced by them on the performance of the university nor on the way stakeholders perceive the usefulness of the knowledge transmitted or the level of customer satisfaction achieved, as indeed the most recent research on the subject envisages.

A study of deficiencies in teamwork skills among Jordan caregivers

2018 ◽  
Vol 31 (4) ◽  
pp. 350-360 ◽  
Author(s):  
Omar Al-Araidah ◽  
Nader Al Theeb ◽  
Mariam Bader ◽  
Nabeel Mandahawi
Keyword(s):  
Quality Of Care ◽  
Leadership Skills ◽  
Training Needs ◽  
Care Providers ◽  
Content Type ◽  
Team Members ◽  
Low Levels ◽  
Teamwork Skills ◽  
The Impact

Purpose The purpose of this paper is to present the deficiencies in teamwork skills at Jordan hospitals as seen by team members. The study aims to identify training needs to improve teamwork-related soft skills of caregivers to enhance staff satisfaction and improve quality of care. Moreover, the paper provides a methodology to identify the training needs in any healthcare workplace by repeating the same questionnaire. Design/methodology/approach A self-administrated questionnaire was designed to study deficiencies in teamwork and team leadership at Jordan hospitals as seen by team members. Surveyed care providers included physicians, nursing and anesthesiologists operating in emergency departments, surgical operating rooms and intensive care units from various hospitals. Findings With a response rate of 78.8 percent, statistical analysis of collected data of opposing staff members revealed low levels of satisfaction (40.7-48 percent opposing), lack of awareness on the impact of teamwork on quality of care (15.6-22.1 percent opposing), low levels of involvement of top management (27.1-57.3 percent opposing), lack of training (52.5-69.8 percent opposing), lack of leadership skills (29.8-60 percent opposing), lack of communication (22.3-62.1 percent opposing), lack of employee involvement (37.6-50.8 percent opposing) and lack of collaboration among team members (28.6-50 percent opposing). Among the many, results illustrate the need for improving leadership skills of team leaders, improving communication and involving team members in decision making. Originality/value Several studies investigated relationships between teamwork skills and quality of care in many countries. To the authors’ knowledge, no local study investigated the deficiencies of teamwork skills among Jordan caregivers and its impact on quality of care. The study provides the ground for management at Jordan hospitals and to healthcare academic departments to tailor training courses to improve teamwork skills of caregivers. Data of this study are collected from the society who is working in the field of healthcare. As the results of this are produced from a real data, it is expected that applying the recommendations will impact the society positively by enhancing the patients’ satisfaction.

scholarly journals Disruptive life event or reflexive instrument? On the regulation of hospital mergers from a quality of care perspective

2020 ◽  
Vol 34 (4) ◽  
pp. 489-503
Author(s):  
David de Kam ◽  
Marianne van Bochove ◽  
Roland Bal
Keyword(s):  
Quality Of Care ◽  
Qualitative Study ◽  
Quality And Safety ◽  
Hospital Mergers ◽  
Content Type ◽  
Daily Care ◽  
Dutch Health ◽  
Care Practices ◽  
The Impact

PurposeDespite the continuation of hospital mergers in many western countries, it is uncertain if and how hospital mergers impact the quality of care. This poses challenges for the regulation of mergers. The purpose of this paper is to understand: how regulators and hospitals frame the impact of merging on the quality and safety of care and how hospital mergers might be regulated, given their uncertain impact on quality and safety of care.Design/methodology/approachThis paper studies the regulation of hospital mergers in The Netherlands. In a qualitative study design, it draws on 30 semi-structured interviews with inspectors from the Dutch Health and Youth Care Inspectorate (Inspectorate) and respondents from three hospitals that merged between 2013 and 2015. This paper draws from literature on process-based regulation to understand how regulators can monitor hospital mergers.FindingsThis paper finds that inspectors and hospital respondents frame the process of merging as potentially disruptive to daily care practices. While inspectors emphasise the dangers of merging, hospital respondents report how merging stimulated them to reflect on their care practices and how it afforded learning between hospitals. Although the Inspectorate considers mergers a risk to quality of care, their regulatory practices are hesitant.Originality/valueThis qualitative study sheds light on how merging might affect key hospital processes and daily care practices. It offers opportunities for the regulation of hospital mergers that acknowledges rather than aims to dispel the uncertain and potentially ambiguous impact of mergers on quality and safety of care.

scholarly journals HRM in healthcare: the role of work engagement

2016 ◽  
Vol 45 (2) ◽  
pp. 274-295 ◽  
Author(s):  
Amanda Shantz ◽  
Kerstin Alfes ◽  
Lilith Arevshatian
Keyword(s):  
Quality Of Care ◽  
Work Engagement ◽  
Administrative Support ◽  
Equation Modeling ◽  
Content Type ◽  
Hrm Practices ◽  
The Impact ◽  
The Relationship

Purpose – Due to increasing cost pressures, and the necessity to ensure high quality patient care while maintaining a safe environment for patients and staff, interest in the capacity for HRM practices to make a difference has piqued the attention of healthcare professionals. The purpose of this papers is to present and test a model whereby engagement mediates the relationship between four HRM practices and quality of care and safety in two different occupational groups in healthcare, namely, nurses and administrative support workers. Design/methodology/approach – Structural equation modeling was used to analyze questionnaire data collected by the National Health Service in the UK as part of their 2011 Staff Survey (n=69,018). The authors tested the hypotheses for nurses and administrative support workers separately. Findings – Training, participation in decision making, opportunities for development, and communication were positively related to quality of care and safety via work engagement. The strength of the relationships was conditional on whether an employee was a nurse or administrative support worker. Originality/value – This is the first paper to examine the mediating role of engagement on the relationship between four relevant HRM practices in the healthcare context, and outcomes important to healthcare practitioners. The authors also add value to the HRM literature by being among the first to use the job demands resources model to explain the impact of HRM practices on performance outcomes. Moreover, the authors provide insight into how HRM practices affect outcomes in the world’s largest publicly funded healthcare service.

Economic and demographic challenges for social care

2014 ◽  
Vol 28 (5) ◽  
pp. 653-673 ◽  
Author(s):  
Will Thomas ◽  
Sue Hollinrake
Keyword(s):  
Quality Of Care ◽  
Older People ◽  
Research Study ◽  
Social Care ◽  
Empirical Work ◽  
Content Type ◽  
Reform Agenda ◽  
Demographic Challenges ◽  
The Impact

Purpose – The purpose of this paper is to analyse the impact of reforms designed to address economic and demographic challenges in England with reference to the authors’ own empirical work providing a critique of their impact and suggesting a way to improve the quality of social care for older people. Design/methodology/approach – The research was a qualitative study conducted in a participatory manner in which older people were positioned as co-creators of the research study. This involved setting the scope of the study and identifying and refining the themes used in the analysis of an inquiry board and interviews. Findings – The research findings highlight the threat of recent moves that emphasise “independence” and “self-management” particularly as they risk marginalising some groups of older people and reducing the quality of care. An alternative approach drawn from the ethics of care is suggested. Research limitations/implications – The research study focused on a narrow selection of older people and future work will wish to explore concepts of “care” and “independence” in additional contexts and of reforms in other geographies. Practical implications – The researchers argue that the current reform agenda threatens the quality of care services and suggest improvements to the way in which services might be organised and presented. Social implications – It is intended that the research will contribute to social policy debates and particularly those that focus on social care. The study also looks to contribute to current work in the fields of critical gerontology, feminist ethics and the management of public services more generally. Originality/value – The paper presents a novel and critical viewpoint of current social care policy in England and will therefore be of interest to policy-makers and to professionals.

scholarly journals Process redesign for time-based emergency admission targets

2016 ◽  
Vol 30 (6) ◽  
pp. 939-949 ◽  
Author(s):  
Sandra G. Leggat ◽  
Richard Gough ◽  
Timothy Bartram ◽  
Pauline Stanton ◽  
Greg J. Bamber ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Management Practices ◽  
Emergency Admission ◽  
Hospital Staff ◽  
Positive Outcome ◽  
Structured Interviews ◽  
Content Type ◽  
Process Redesign ◽  
The Impact

Purpose Hospitals have used process redesign to increase the efficiency of the emergency department (ED) to cope with increasing demand. While there are published studies suggesting a positive outcome, recent reviews have reported that it is difficult to conclude that these approaches are effective as a result of substandard research methodology. The purpose of this paper is to explore the perceptions of hospital staff on the impact of a process redesign initiative on quality of care. Design/methodology/approach A retrospective qualitative case study examining a Lean Six Sigma (LSS) initiative in a large metropolitan hospital from 2009 to 2010. Non-probability sampling identified interview subjects who, through their participation in the redesign initiative, had a detailed understanding of the implementation and outcomes of the initiative. Between April 2012 and January 2013 26 in-depth semi-structured interviews were conducted and analysed with thematic content analysis. Findings There were four important findings. First, when asked to comment on the impact of the LSS implementation, without prompting the staff spoke of quality of care. Second, there was little agreement among the participants as to whether the project had been successful. Third, despite the recognition of the need for a coordinated effort across the hospital to improve ED access, the redesign process was not successful in reducing existing divides among clinicians and among managers and clinicians. Finally, staff expressed tension between production processes to move patients more quickly and their duty of care to their patients as individuals. Originality/value One of the first studies to explore the impact of process redesign through in-depth interviews with participating staff, this study adds further evidence that organisations implementing process redesign must ensure the supporting management practices are in place.

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