The use of external change agents to promote quality improvement and organizational change in healthcare organizations: a systematic review

Quality improvement is a strategic process which requires a breakthrough in the traditional resistance to change generally experienced in most companies. The management of quality improvement is in reality the management of organizational change. So how do organizations become aware that they need to change their approach, behaviour and attitudes to the issue of quality improvement? This paper discusses some possible quality improvement change agents, including: the Chief Executive; competition; demanding customers; a greenfield venture (which may be created artificially); and a restart situation. The case studies presented also outline the factors that contribute to the effectiveness of the change agents in specific situations.

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Metaphors of organizations in patient involvement programs: connections and contradictions

Journal of Health Organization and Management ◽

10.1108/jhom-07-2020-0292 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Paula Rowland ◽

Carol Fancott ◽

Julia Abelson

Keyword(s):

Organizational Change ◽

Quality Improvement ◽

Patient Engagement ◽

Design Methodology ◽

Patient Involvement ◽

Sociology Of Knowledge ◽

Healthcare Organizations ◽

Organizational Improvement ◽

Content Type

PurposeIn this paper, we contribute to the theorizing of patient involvement in organizational improvement by exploring concepts of “learning from patients” as mechanisms of organizational change. Using the concept of metaphor as a theoretical bridge, we analyse interview data (n = 20) from participants in patient engagement activities from two case study organizations in Ontario, Canada. Inspired by classic organizational scholars, we ask “what is the organization that it might learn from patients?”Design/methodology/approachPatient involvement activities are used as part of quality improvement efforts in healthcare organizations worldwide. One fundamental assumption underpinning this activity is the notion that organizations must “learn from patients” in order to enact positive organizational change. Despite this emphasis on learning, there is a paucity of research that theorizes learning or connects concepts of learning to organizational change within the domain of patient involvement.FindingsThrough our analysis, we interpret a range of metaphors of the organization, including organizations as (1) power and politics, (2) systems and (3) narratives. Through these metaphors, we display a range of possibilities for interpreting how organizations might learn from patients and associated implications for organizational change.Originality/valueThis analysis has implications for how the framing of the organization matters for concepts of learning in patient engagement activities and how misalignments might stymie engagement efforts. We argue that the concept and commitment to “learning from patients” would be enriched by further engagement with the sociology of knowledge and critical concepts from theories of organizational learning.

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A Study on Employee Attitude towards Organizational Change and the impact of Change Management on Organization Commitment

Restaurant Business ◽

10.26643/rb.v118i3.7639 ◽

2019 ◽

Vol 118 (3) ◽

pp. 158-169

Author(s):

Dheera.V. R ◽

Jayasree Krishnan

Keyword(s):

Organizational Change ◽

Change Management ◽

Tamil Nadu ◽

Change Agents ◽

Organization Change ◽

Sustainable Growth ◽

Positive Approach ◽

Organizational Goals ◽

Organization Commitment ◽

The Impact

Organizations that are aiming to successfully implement change needs the support and acceptance of employees who are their key stakeholder. This study analyses the influence of Employees` attitude towards organization change. The research also aims at evaluating the influence of employees’ attitude towards commitment to organization and job after the introduction of change in the organization. The study was conducted among 300 employees who belonged to executive and managerial category from different star rated hotels in Chennai, Tamil Nadu, India which are currently embracing organization changes. The findings indicate that employees of the study demonstrate a positive approach towards the change management in their organization. The observations also project that a positive approach by employees towards changes, is a very good indication for organizations to know that their workforce is committed towards the organizational goals. Hence with the support of change agents, adequate communications and by creating awareness about the need for change will result in sustainable growth in the organizations.

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Patientsʼ involvement in their own care through quality improvement initiatives: a systematic review of qualitative and opinion evidence

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/01938924-201210570-00007 ◽

2012 ◽

Vol 10 (57) ◽

pp. 3936-3948

Author(s):

Claire van Deventer ◽

Patricia McInerney

Keyword(s):

Systematic Review ◽

Quality Improvement

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Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽

10.3390/healthcare9050528 ◽

2021 ◽

Vol 9 (5) ◽

pp. 528

Author(s):

Cristian Lieneck ◽

Brooke Herzog ◽

Raven Krips

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Care Services ◽

Care Delivery ◽

Routine Care ◽

Future Research ◽

Healthcare Organizations ◽

Care Services ◽

Global Pandemic ◽

Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

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Setting the standard for healthy eating: Continuous quality improvement for health promotion at Nova Scotia Health

Healthcare Management Forum ◽

10.1177/0840470420967705 ◽

2020 ◽

Vol 34 (1) ◽

pp. 49-55

Author(s):

Laura J. Kennedy ◽

Nathan G. A. Taylor ◽

Taylor Nicholson ◽

Emily Jago ◽

Brenda L. MacDonald ◽

...

Keyword(s):

Health Promotion ◽

Quality Improvement ◽

Nova Scotia ◽

Healthy Eating ◽

Continuous Quality Improvement ◽

Healthcare Organizations ◽

Quality Improvement Process ◽

Continuous Quality ◽

The Status ◽

Collaborative Efforts

Healthcare organizations engage in continuous quality improvement to improve performance and value-for-performance, but the pathway to change is often rooted in challenging the way things are “normally” done. In an effort to propel system-wide change to support healthy eating, Nova Scotia Health developed and implemented a healthy eating policy as a benchmark to create a food environment supportive of health. This article describes the healthy eating policy and its role as a benchmark in the quality improvement process. The policy, rooted in health promotion, sets a standard for healthy eating and applies to stakeholders both inside and outside of health. We explain how the policy offers nutrition but also cultural benchmarks around healthy eating, bringing practitioners throughout Nova Scotia Health together and sustaining collaborative efforts to improve upon the status quo.

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Do quality improvement initiatives for diabetes care address social inequities? Secondary analysis of a systematic review

BMJ Open ◽

10.1136/bmjopen-2017-018826 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018826 ◽

Cited By ~ 5

Author(s):

Jacquie Boyang Lu ◽

Kristin J Danko ◽

Michael D Elfassy ◽

Vivian Welch ◽

Jeremy M Grimshaw ◽

...

Keyword(s):

Systematic Review ◽

Socioeconomic Status ◽

Quality Improvement ◽

Diabetes Care ◽

Secondary Analysis ◽

Place Of Residence ◽

Disadvantaged Groups ◽

Disadvantaged Populations ◽

Patients With Diabetes ◽

Race Ethnicity

BackgroundSocially disadvantaged populations carry a disproportionate burden of diabetes-related morbidity and mortality. There is an emerging interest in quality improvement (QI) strategies in the care of patients with diabetes, however, the effect of these interventions on disadvantaged groups remains unclear.ObjectiveThis is a secondary analysis of a systematic review that seeks to examine the extent of equity considerations in diabetes QI studies, specifically quantifying the proportion of studies that target interventions toward disadvantaged populations and conduct analyses on the impact of interventions on disadvantaged groups.Research design and methodsStudies were identified using Medline, HealthStar and the Cochrane Effective Practice and Organisation of Care database. Randomised controlled trials assessing 12 QI strategies targeting health systems, healthcare professionals and/or patients for the management of adult outpatients with diabetes were eligible. The place of residence, race/ethnicity/culture/language, occupational status, gender/sexual identity, religious affiliations, education level, socioeconomic status, social capital, plus age, disability, sexual preferences and relationships (PROGRESS-Plus) framework was used to identify trials that focused on disadvantaged patient populations, to examine the types of equity-relevant factors that are being considered and to explore temporal trends in equity-relevant diabetes QI trials.ResultsOf the 278 trials that met the inclusion criteria, 95 trials had equity-relevant considerations. These include 64 targeted trials that focused on a disadvantaged population with the aim to improve the health status of that population and 31 general trials that undertook subgroup analyses to assess the extent to which their interventions may have had differential impacts on disadvantaged subgroups. Trials predominantly focused on race/ethnicity, socioeconomic status and place of residence as potential factors for disadvantage in patients receiving diabetes care.ConclusionsLess than one-third of diabetes QI trials included equity-relevant considerations, limiting the relevance and applicability of their data to disadvantaged populations. There is a need for better data collection, reporting, analysis and interventions on the social determinants of health that may influence the health outcomes of patients with diabetes.PROSPERO registration numberCRD42013005165.

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