Health Professions › Health Information Management

Healthcare Quality and Management

Works Count: 41939

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Description

This cluster of papers focuses on the impact of healthcare accreditation on quality improvement, clinical governance, hospital performance, patient satisfaction, and organizational change. It explores topics such as quality management systems, public health policy, and healthcare regulation in the context of accreditation. The papers analyze the challenges, benefits, and effectiveness of accreditation programs in healthcare organizations.

Keywords

Healthcare Accreditation; Quality Improvement; Clinical Governance; Hospital Performance; Patient Satisfaction; Health Service Evaluation; Organizational Change; Quality Management Systems; Public Health Policy; Healthcare Regulation

Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

1995-06-01

Stephen M. Shortell , J. L. O'Brien , James M. Carman +4 more

This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals.Primary data were collected from 61 U. … This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals.Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions.The study involved cross-sectional examination of the named relationships.Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care.A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation.What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult challenges in this regard.

The Influence of Context on Quality Improvement Success in Health Care: A Systematic Review of the Literature

2010-12-01

Heather C. Kaplan , Patrick W. Brady , Michele C. Dritz +4 more

Context: The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. Methods: The business and health care literature was systematically reviewed … Context: The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. Methods: The business and health care literature was systematically reviewed to identify contextual factors that might influence QI success; to categorize, summarize, and synthesize these factors; and to understand the current stage of development of this research field. Findings: Forty-seven articles were included in the final review. Consistent with current theories of implementation and organization change, leadership from top management, organizational culture, data infrastructure and information systems, and years involved in QI were suggested as important to QI success. Other potentially important factors identified in this review included: physician involvement in QI, microsystem motivation to change, resources for QI, and QI team leadership. Key limitations in the existing literature were the lack of a practical conceptual model, the lack of clear definitions of contextual factors, and the lack of well-specified measures. Conclusions: Several contextual factors were shown to be important to QI success, although the current body of literature lacks adequate definitions and is characterized by considerable variability in how contextual factors are measured across studies. Future research should focus on identifying and developing measures of context tied to a conceptual model that examines context across all levels of the health care system and explores the relationships among various aspects of context.

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Improving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change

2001-06-01

Ewan Ferlı́e , Stephen M. Shortell

Fueled by public incidents and growing evidence of deficiencies in care, concern over the quality and outcomes of care has increased in both the United Kingdom and the United States. … Fueled by public incidents and growing evidence of deficiencies in care, concern over the quality and outcomes of care has increased in both the United Kingdom and the United States. Both countries have launched a number of initiatives to deal with these issues. These initiatives are unlikely to achieve their objectives without explicit consideration of the multilevel approach to change that includes the individual, group/team, organization, and larger environment/system level. Attention must be given to issues of leadership, culture, team development, and information technology at all levels. A number of contingent factors influence these efforts in both countries, which must each balance a number of tradeoffs between centralization and decentralization in efforts to sustain the impetus for quality improvement over time. The multilevel change framework and associated properties provide a framework for assessing progress along the journey.

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Quality assessment in health.

1984-05-12

R J Maxwell

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Lean in healthcare: A comprehensive review

2015-02-11

Antonio D’Andreamatteo , Luca Ianni , Federico Lega +1 more

`Two-Way Windows': Clinicians as Medical Managers

2001-07-01

Sue Llewellyn

This paper uses the metaphor of the `two-way window' to understand the aspirations and activities of clinical directors (doctors with management responsibilities). Clinical directors work simultaneously with sets of ideas … This paper uses the metaphor of the `two-way window' to understand the aspirations and activities of clinical directors (doctors with management responsibilities). Clinical directors work simultaneously with sets of ideas from both clinical practice and from management, therefore, their role (as `two-way windows') allows the possibility to create a new area of expertise — medical-management. To explore how `two-way windows' are being constituted, clinician managers in three medical organizations were interviewed. Three narratives were constructed from their accounts. The first narrative outlines the theories-in-use of clinical directors, the second and third consist of the strategizing of clinical directors as they seek to maintain their primary focus on clinical work whilst, at the same time, developing their management expertise and influence. The paper concludes that clinical directors can relatively easily occupy the `two-way' space opened up by the mediation of medicine and management. Only a lack of financial management expertise renders their new organizational positioning vulnerable. All public bureaucracies now involve complex mediation between professionals and managers; hence, `two-way windows' will become increasingly significant in organizational development. These `two-way' roles privilege professional over managerial expertise as it is assumed that the appropriate professional training is of paramount importance. Unique professional/managerial discourses are being created in public-sector organizations. This paper provides a basis for understanding the development of such discourses.

Lean in healthcare: The unfilled promise?

2011-03-07

Zoe Radnor , Matthias Holweg , Justin Waring

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The relationship of organizational culture, stress, satisfaction, and burnout with physician-reported error and suboptimal patient care

2007-07-01

Eric S. Williams , Linda Baier Manwell , Thomas R. Konrad +1 more

A report by the Institute of Medicine suggests that changing the culture of health care organizations may improve patient safety. Research in this area, however, is modest and inconclusive. Because … A report by the Institute of Medicine suggests that changing the culture of health care organizations may improve patient safety. Research in this area, however, is modest and inconclusive. Because culture powerfully affects providers, and providers are a key determinant of care quality, the MEMO study (Minimizing Error, Maximizing Outcome) introduces a new model explaining how physician work attitudes may mediate the relationship between culture and patient safety.(1) Which cultural conditions affect physician stress, dissatisfaction, and burnout? and (2) Do stressed, dissatisfied, and burned out physicians deliver poorer quality care?A conceptual model incorporating the research questions was analyzed via structural equation modeling using a sample of 426 primary care physicians participating in MEMO.Culture, overall, played a lesser role than hypothesized. However, a cultural emphasis on quality played a key role in both quality outcomes. Further, we found that stressed, burned out, and dissatisfied physicians do report a greater likelihood of making errors and more frequent instance of suboptimal patient care.Creating and sustaining a cultural emphasis on quality is not an easy task, but is worthwhile for patients, physicians, and health care organizations. Further, having clinicians who are satisfied and not burned out or stressed contributes substantially to the delivery of quality care.

Quality counts in services, too

1985-05-01

Leonard L. Berry , Valarie A. Zeithaml , A. Parasuraman

Lean health care: What can hospitals learn from a world‐class automaker?

2006-05-01

Christopher S. Kim , David A. Spahlinger , Jeanne M. Kin +1 more

Abstract BACKGROUND With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is … Abstract BACKGROUND With health care costs continuing to rise, a variety of process improvement methodologies have been proposed to address the reported inefficiencies in health care delivery. Lean production is one such method. The management philosophy and tools of lean production come from the manufacturing industry, where they were pioneered by Toyota Motor Corporation, which is viewed as the leader in utilizing these performance improvement methods. Lean has already enjoyed tremendous success in improving quality and efficiency in both the manufacturing and the service sector industries. RESULTS Health care systems have just begun to utilize lean methods, with reports of improvements just beginning to appear in the literature. We describe some of the basic philosophy and principles of lean production methods and how these concepts can be applied in the health care environment. We describe some of the early success stories and ongoing endeavors of lean production in various health care organizations. We believe the hospital is an ideal setting for use of the lean production method, which could significantly affect how health care is delivered to patients. CONCLUSIONS We conclude by discussing some of the potential challenges in introducing and implementing lean production methods in the health care environment. Lean production is a novel approach to delivering high‐quality and efficient care to patients, and we believe that the health care sector can anticipate the same high level of success that the manufacturing and service industries have achieved using this approach. Hospitalists are primed to take action in delivering care of greater quality with more efficiency by applying these new principles in the hospital setting. Journal of Hospital Medicine 2006;1:191–199. © 2006 Society of Hospital Medicine.

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An institutional theory perspective on the DRG framework, case-mix accounting systems and health-care organizations

1993-01-01

Mark A. Covaleski , Mark W. Dirsmith , Jeffrey E. Michelman

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Dynamic professional boundaries in the healthcare workforce

2005-11-01

Susan Nancarrow , Alan Borthwick

The healthcare professions have never been static in terms of their own disciplinary boundaries, nor in their role or status in society. Healthcare provision has been defined by changing societal … The healthcare professions have never been static in terms of their own disciplinary boundaries, nor in their role or status in society. Healthcare provision has been defined by changing societal expectations and beliefs, new ways of perceiving health and illness, the introduction of a range of technologies and, more recently, the formal recognition of particular groups through the introduction of education and regulation. It has also been shaped by both inter-professional and profession-state relationships forged over time. A number of factors have converged that place new pressures on workforce boundaries, including an unmet demand for some healthcare services; neo-liberal management philosophies and a greater emphasis on consumer preferences than professional-led services. To date, however, there has been little analysis of the evolution of the workforce as a whole. The discussion of workforce change that has taken place has largely been from the perspective of individual disciplines. Yet the dynamic boundaries of each discipline mean that there is an interrelationship between the components of the workforce that cannot be ignored. The purpose of this paper is to describe four directions in which the existing workforce can change: diversification; specialisation and vertical and horizontal substitution, and to discuss the implications of these changes for the workforce.

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Health sector reform and public sector health worker motivation: a conceptual framework

2002-04-01

Lynne Miller Franco , Sara Bennett , Ruth Kanfer

Patients and staff as codesigners of healthcare services

2015-02-10

Glenn Robert , Jocelyn Cornwell , Louise Locock +3 more

Glenn Robert and colleagues describe an approach that aims to ensure that healthcare organisations realise the full potential of patients—the biggest resource they have for improving the quality of care Glenn Robert and colleagues describe an approach that aims to ensure that healthcare organisations realise the full potential of patients—the biggest resource they have for improving the quality of care

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The Quantitative Measurement of Organizational Culture in Health Care: A Review of the Available Instruments

2003-05-23

Tim Scott , Russell Mannion , Huw Davies +1 more

Objective. To review the quantitative instruments available to health service researchers who want to measure culture and cultural change. Data Sources. A literature search was conducted using Medline, Cinahl, Helmis, … Objective. To review the quantitative instruments available to health service researchers who want to measure culture and cultural change. Data Sources. A literature search was conducted using Medline, Cinahl, Helmis, Psychlit, Dhdata, and the database of the King's Fund in London for articles published up to June 2001, using the phrase “organizational culture.” In addition, all citations and the gray literature were reviewed and advice was sought from experts in the field to identify instruments not found on the electronic databases. The search focused on instruments used to quantify culture with a track record, or potential for use, in health care settings. Data Extraction. For each instrument we examined the cultural dimensions addressed, the number of items for each questionnaire, the measurement scale adopted, examples of studies that had used the tool, the scientific properties of the instrument, and its strengths and limitations. Principal Findings. Thirteen instruments were found that satisfied our inclusion criteria, of which nine have a track record in studies involving health care organizations. The instruments varied considerably in terms of their grounding in theory, format, length, scope, and scientific properties. Conclusions. A range of instruments with differing characteristics are available to researchers interested in organizational culture, all of which have limitations in terms of their scope, ease of use, or scientific properties. The choice of instrument should be determined by how organizational culture is conceptualized by the research team, the purpose of the investigation, intended use of the results, and availability of resources.

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Hospital Quality for Acute Myocardial Infarction

2006-07-05

Elizabeth H. Bradley , Jeph Herrin , Brian Elbel +7 more

ContextThe Centers for Medicare & Medicaid Services (CMS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) measure and report quality process measures for acute myocardial infarction (AMI), but … ContextThe Centers for Medicare & Medicaid Services (CMS) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) measure and report quality process measures for acute myocardial infarction (AMI), but little is known about how these measures are correlated with each other and the degree to which inferences about a hospital's outcomes can be made from its performance on publicly reported processes.ObjectiveTo determine correlations among AMI core process measures and the degree to which they explain the variation in hospital-specific, risk-standardized, 30-day mortality rates.Design, Setting, and ParticipantsWe assessed hospital performance in the CMS/JCAHO AMI core process measures using 2002-2003 data from 962 hospitals participating in the National Registry of Myocardial Infarction (NRMI) and correlated these measures with each other and with hospital-level, risk-standardized, 30-day mortality rates derived from Medicare claims data.Main Outcome MeasuresHospital performance on AMI core measures; hospital-specific, risk-standardized, 30-day mortality rates for AMI patients aged 66 years or older.ResultsWe found moderately strong correlations (correlation coefficients ≥0.40; P values <.001) for all pairwise comparisons between β-blocker use at admission and discharge, aspirin use at admission and discharge, and angiotensin-converting enzyme inhibitor use, and weaker, but statistically significant, correlations between these medication measures and smoking cessation counseling and time to reperfusion therapy measures (correlation coefficients <0.40; P values <.001). Some process measures were significantly correlated with risk-standardized, 30-day mortality rates (P values <.001) but together explained only 6.0% of hospital-level variation in risk-standardized, 30-day mortality rates for patients with AMI.ConclusionsThe publicly reported AMI process measures capture a small proportion of the variation in hospitals' risk-standardized short-term mortality rates. Multiple measures that reflect a variety of processes and also outcomes, such as risk-standardized mortality rates, are needed to more fully characterize hospital performance.

Organizational Discretion in Responding to Institutional Practices: Hospitals and Cesarean Births

1996-03-01

Elizabeth Goodrick , Gerald R. Salancik

The authors thank Rob Burns, Huseyin Leblebici, Ann Flood, and Randy Brown for comments on earlier versions of this paper. This paper has also benefited from the helpful comments of … The authors thank Rob Burns, Huseyin Leblebici, Ann Flood, and Randy Brown for comments on earlier versions of this paper. This paper has also benefited from the helpful comments of the associate editor, Christine Oliver, as well as the feedback provided by the three anonymous ASO reviewers. The data were generously provided by Ronald L. Williams, Community and Organization Research Institute, University of California. While others have tried to accommodate agency and interests within institutional theory by directly incorporating a strategic choice perspective, we propose here that institutions are primary and exist as the context within which interests operate. We argue that uncertainty provides discretion, implying that organizational influence on practice will be greatest when institutional standards are most uncertain. We examine these arguments in the context of cesarean section surgeries in hospitals with different ownership and teaching structures. As expected, we found that hospitals' characteristics were influential in determining the use of cesareans only when the level of institutional uncertainty was high, that is, when patient risk was at an intermediate rather than a high or low level.*

Is Health Care Ready for Six Sigma Quality?

1998-12-01

Mark R. Chassin

Serious, widespread problems exist in the quality of U.S. health care: too many patients are exposed to the risks of unnecessary services; opportunities to use effective care are missed; and … Serious, widespread problems exist in the quality of U.S. health care: too many patients are exposed to the risks of unnecessary services; opportunities to use effective care are missed; and preventable errors lead to injuries. Advanced practitioners of industrial quality management, like Motorola and General Electric, have committed themselves to reducing the frequency of defects in their business processes to fewer than 3.4 per million, a strategy known as Six Sigma Quality. In health care, quality problems frequently occur at rates of 20 to 50 percent, or 200,000 to 500,000 per million. In order to approach Six Sigma levels of quality, the health care sector must address the underlying causes of error and make important changes: adopting new educational models; devising strategies to increase consumer awareness; and encouraging public and private investment in quality improvement.

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The shocking cost of turnover in health care

2010-07-01

J. Deane Waldman , Frank Kelly , Sanjeev Arora +1 more

Review of turnover costs at a major medical center helps health care managers gain insights about the magnitude and determinants of this managerial challenge and assess the implications for organizational … Review of turnover costs at a major medical center helps health care managers gain insights about the magnitude and determinants of this managerial challenge and assess the implications for organizational effectiveness. Here, turnover includes hiring, training, and productivity loss costs. Minimum cost of turnover represented a loss of >5 percent of the total annual operating budget. Editor's Note: This article is being reprinted with permission from Health Care Management Review 29(1), 2-7. Copyright © 2009 Lippincott Williams & Wilkins.

Use and misuse of process and outcome data in managing performance of acute medical care: avoiding institutional stigma

2004-04-01

Richard Lilford , Mohammed A. Mohammed , David J. Spiegelhalter +1 more

Joint Commission on Accreditation of Healthcare Organizations

1995-01-01

Carole H. Patterson

Abstract The Joint Commission on Accreditation of Healthcare Organizations was founded in 1951 as a private, not-for-profit organization that evaluates and accredits hospitals and other healthcare organizations. In 1987, the … Abstract The Joint Commission on Accreditation of Healthcare Organizations was founded in 1951 as a private, not-for-profit organization that evaluates and accredits hospitals and other healthcare organizations. In 1987, the JCAHO launched its Agenda for Change to create a more modem and sophisticated accreditation process to place primary emphasis on actual performance. Coincident with this new emphasis, a number of task forces were established, including two for infection control standards.

The Promise of Lean in Health Care

2012-12-27

John S. Toussaint , Leonard L. Berry

Audit and feedback: effects on professional practice and healthcare outcomes

2012-06-08

Noah Ivers , Gro Jamtvedt , Signe Flottorp +7 more

Culture and behaviour in the English National Health Service: overview of lessons from a large multimethod study

2013-09-09

Mary Dixon‐Woods , Richard Baker , Kathryn Charles +7 more

Background Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS). Methods … Background Problems of quality and safety persist in health systems worldwide. We conducted a large research programme to examine culture and behaviour in the English National Health Service (NHS). Methods Mixed-methods study involving collection and triangulation of data from multiple sources, including interviews, surveys, ethnographic case studies, board minutes and publicly available datasets. We narratively synthesised data across the studies to produce a holistic picture and in this paper present a high-level summary. Results We found an almost universal desire to provide the best quality of care. We identified many ‘bright spots’ of excellent caring and practice and high-quality innovation across the NHS, but also considerable inconsistency. Consistent achievement of high-quality care was challenged by unclear goals, overlapping priorities that distracted attention, and compliance-oriented bureaucratised management. The institutional and regulatory environment was populated by multiple external bodies serving different but overlapping functions. Some organisations found it difficult to obtain valid insights into the quality of the care they provided. Poor organisational and information systems sometimes left staff struggling to deliver care effectively and disempowered them from initiating improvement. Good staff support and management were also highly variable, though they were fundamental to culture and were directly related to patient experience, safety and quality of care. Conclusions Our results highlight the importance of clear, challenging goals for high-quality care. Organisations need to put the patient at the centre of all they do, get smart intelligence, focus on improving organisational systems, and nurture caring cultures by ensuring that staff feel valued, respected, engaged and supported.

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The Quality in Australian Health Care Study

1995-11-01

R. M. Wilson , W. B. Runciman , Robert Gibberd +3 more

A review of the medical records of over 14 000 admissions to 28 hospitals in New South Wales and South Australia revealed that 16.6% of these admissions were associated with … A review of the medical records of over 14 000 admissions to 28 hospitals in New South Wales and South Australia revealed that 16.6% of these admissions were associated with an "adverse event", which resulted in disability or a longer hospital stay for the patient and was caused by health care management; 51% of the adverse events were considered preventable. In 77.1% the disability had resolved within 12 months, but in 13.7% the disability was permanent and in 4.9% the patient died.

Evaluating the Quality of Medical Care

2005-11-09

Avedis Donabedian

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Institutional Logics and Institutional Pluralism: The Contestation of Care and Science Logics in Medical Education, 1967–2005

2010-03-01

Mary B. Dunn , Candace Jones

Although most studies underscore institutional change as replacement of one dominant logic for another and assume that professions are guided by a single logic, professions that operate in multiple institutional … Although most studies underscore institutional change as replacement of one dominant logic for another and assume that professions are guided by a single logic, professions that operate in multiple institutional spheres often have plural logics. We focus on medical education, the supplier of medical professionals, which resides at the interstices between academia and healthcare. Using archival sources from 1910 to 2005, we identify two logics central to the profession that persisted over time: care and science. We found that jurisdictional competition with rivals such as public health, contestation among physicians, the rise of managed care, and increasing numbers of women entering medical schools are associated with increased attention to the care logic. Differentiation in the missions of medical schools is associated with reduced attention to the science logic. Our study reveals that plural logics of care and science in medical education are supported by distinct groups and interests, fluctuate over time, and create dynamic tensions about how to educate future professionals.

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Quality of Care in U.S. Hospitals as Reflected by Standardized Measures, 2002–2004

2005-07-20

Scott C. Williams , Stephen Schmaltz , David J. Morton +2 more

In July 2002, the Joint Commission on Accreditation of Healthcare Organizations implemented standardized performance measures that were designed to track the performance of accredited hospitals and encourage improvement in the … In July 2002, the Joint Commission on Accreditation of Healthcare Organizations implemented standardized performance measures that were designed to track the performance of accredited hospitals and encourage improvement in the quality of health care.We examined hospitals' performance on 18 standardized indicators of the quality of care for acute myocardial infarction, heart failure, and pneumonia. One measure assessed a clinical outcome (death in the hospital after acute myocardial infarction), and the other 17 measures assessed processes of care. Data were collected over a two-year period in more than 3000 accredited hospitals. All participating hospitals received quarterly feedback in the form of comparative reports throughout the study.Descriptive analysis revealed a significant improvement (P<0.01) in the performance of U.S. hospitals on 15 of 18 measures, and no measure showed a significant deterioration. The magnitude of improvement ranged from 3 percent to 33 percent during the eight quarters studied. For 16 of the 17 process-of-care measures, hospitals with a low level of performance at baseline had greater improvements over the subsequent two years than hospitals with a high level of performance at baseline.Over a two-year period, we observed consistent improvement in measures reflecting the process of care for acute myocardial infarction, heart failure, and pneumonia. Both quantitative and qualitative research are needed to explore the reasons for these improvements.

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The Model for Understanding Success in Quality (MUSIQ): building a theory of context in healthcare quality improvement

2011-08-10

Heather C. Kaplan , Lloyd Provost , Craig M. Froehle +1 more

Background Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the … Background Quality improvement (QI) efforts have become widespread in healthcare, however there is significant variability in their success. Differences in context are thought to be responsible for some of the variability seen. Objective To develop a conceptual model that can be used by organisations and QI researchers to understand and optimise contextual factors affecting the success of a QI project. Methods 10 QI experts were provided with the results of a systematic literature review and then participated in two rounds of opinion gathering to identify and define important contextual factors. The experts subsequently met in person to identify relationships among factors and to begin to build the model. Results The Model for Understanding Success in Quality (MUSIQ) is organised based on the level of the healthcare system and identifies 25 contextual factors likely to influence QI success. Contextual factors within microsystems and those related to the QI team are hypothesised to directly shape QI success, whereas factors within the organisation and external environment are believed to influence success indirectly. Conclusions The MUSIQ framework has the potential to guide the application of QI methods in healthcare and focus research. The specificity of MUSIQ and the explicit delineation of relationships among factors allows a deeper understanding of the mechanism of action by which context influences QI success. MUSIQ also provides a foundation to support further studies to test and refine the theory and advance the field of QI science.

Impact of Accreditation on the Quality of Healthcare Services: a Systematic Review of the Literature

2011-07-01

Abdullah Alkhenizan , C. Shaw

Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards. The aim of this study was … Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards. The aim of this study was to evaluate the impact of accreditation programs on the quality of healthcare servicesWe did a systematic review of the literature to evaluate the impact of accreditation programs on the quality of healthcare services. Several databases were systematically searched, including Medline, Embase, Healthstar, and Cinhal.Twenty-six studies evaluating the impact of accreditation were identified. The majority of the studies showed general accreditation for acute myocardial infarction (AMI), trauma, ambulatory surgical care, infection control and pain management; and subspecialty accreditation programs to significantly improve the process of care provided by healthcare services by improving the structure and organization of healthcare facilities. Several studies showed that general accreditation programs significantly improve clinical outcomes and the quality of care of these clinical conditions and showed a significant positive impact of subspecialty accreditation programs in improving clinical outcomes in different subspecialties, including sleep medicine, chest pain management and trauma management.There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services.

Lean thinking in healthcare: a realist review of the literature

2010-08-19

Pamela Mazzocato , Carl Savage , Mats Brommels +2 more

To understand how lean thinking has been put into practice in healthcare and how it has worked.A realist literature review. Data sources The authors systematically searched for articles in PubMed, … To understand how lean thinking has been put into practice in healthcare and how it has worked.A realist literature review. Data sources The authors systematically searched for articles in PubMed, Web of Science and Business Source Premier (January 1998 to February 2008) and then added articles through a snowball approach.The authors included empirical studies of lean thinking applications in healthcare and excluded those articles that did not influence patient care, or reported hybrid approaches. The authors conducted a thematic analysis based on data collected using an original abstraction form. Based on this, they articulated interactions between context, lean interventions, mechanisms and outcomes.The authors reviewed 33 articles and found a wide range of lean applications. The articles describe initial implementation stages and emphasise technical aspects. All articles report positive results. The authors found common contextual aspects which interact with different components of the lean interventions and trigger four different change mechanisms: understand processes to generate shared understanding; organise and design for effectiveness and efficiency; improve error detection to increase awareness and process reliability; and collaborate to systematically solve problems to enhance continual improvement.Lean thinking has been applied successfully in a wide variety of healthcare settings. While lean theory emphasises a holistic view, most cases report narrower technical applications with limited organisational reach. To better realise the potential benefits, healthcare organisations need to directly involve senior management, work across functional divides, pursue value creation for patients and other customers, and nurture a long-term view of continual improvement.

Evidence‐based Management: From Theory to Practice in Health Care

2001-09-01

Kieran Walshe , Thomas G. Rundall

The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in … The rise of evidence-based clinical practice in health care has caused some people to start questioning how health care managers and policymakers make decisions, and what role evidence plays in the process. Though managers and policymakers have been quick to encourage clinicians to adopt an evidence-based approach, they have been slower to apply the same ideas to their own practice. Yet, there is evidence that the same problems (of the underuse of effective interventions and the overuse of ineffective ones) are as widespread in health care management as they are in clinical practice. Because there are important differences between the culture, research base, and decision-making processes of clinicians and managers, the ideas of evidence-based practice, while relevant, need to be translated for management rather than simply transferred. The experience of the Center for Health Management Research (CHMR) is used to explore how to bring managers and researchers together and promote the use of evidence in managerial decision-making. However, health care funders, health care organizations, research funders, and academic centers need wider and more concerted action to promote the development of evidence-based managerial practice.

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An Introduction to Quality Assurance in Health Care

2003-07-29

Michael Perides

Oxford University Press, 2002 0-19-515809-1; 240 pp; $37.95 Hb, $32.25 Pb It would seem that any discussion about almost any issue in recent times has had to have the word … Oxford University Press, 2002 0-19-515809-1; 240 pp; $37.95 Hb, $32.25 Pb It would seem that any discussion about almost any issue in recent times has had to have the word ‘quality’ peppered liberally throughout the exchange. This apparent obsession with a concept that many have argued has no universal language with which to define it has all too often caused confusion and an inability to truly understand what a quality product or service represents. Nowhere is this more apparent than in health care. For some, the acid test of a quality health care service is the survival of the patient, even though this takes no account of the quality of the patient experience during the treatment process. For others it is the successful completion of the procedure, bringing forth the somewhat macabre statement ‘the operation was a success but unfortunately the patient died’. However, Professor Avedis Donabedian brings a refreshing clarity to this important area through a highly readable yet in-depth exploration of the fundamental ingredients that are essential to delivering a quality service within modern health care. He begins by sharing his definition of quality assurance, and in doing so exposes the weakness …

The relationship between nursing leadership and patient outcomes: a systematic review update

2013-07-01

Carol Wong , Greta G. Cummings , Lisa Ducharme

Aim Our aim was to describe the findings of a systematic review of studies that examine the relationship between nursing leadership practices and patient outcomes. Background As healthcare faces an … Aim Our aim was to describe the findings of a systematic review of studies that examine the relationship between nursing leadership practices and patient outcomes. Background As healthcare faces an economic downturn, stressful work environments, upcoming retirements of leaders and projected workforce shortages, implementing strategies to ensure effective leadership and optimal patient outcomes are paramount. However, a gap still exists in what is known about the association between nursing leadership and patient outcomes. Methods Published English-only research articles that examined leadership practices of nurses in formal leadership positions and patient outcomes were selected from eight online bibliographic databases. Quality assessments, data extraction and analysis were completed on all included studies. Results A total of 20 studies satisfied our inclusion criteria and were retained. Current evidence suggests relationships between positive relational leadership styles and higher patient satisfaction and lower patient mortality, medication errors, restraint use and hospital-acquired infections. Conclusions The findings document evidence of a positive relationship between relational leadership and a variety of patient outcomes, although future testing of leadership models that examine the mechanisms of influence on outcomes is warranted. Implications for nursing management Efforts by organisations and individuals to develop transformational and relational leadership reinforces organisational strategies to improve patient outcomes.

Forgive and Remember: Managing Medical Failure.

1981-09-01

Robert S. Broadhead , Charles L. Bosk

Forgive and Remember is a work about errors in the practice of surgery, written by a sociologist who spent 18 months with the surgical service of a major American teaching … Forgive and Remember is a work about errors in the practice of surgery, written by a sociologist who spent 18 months with the surgical service of a major American teaching hospital.

Application of lean thinking to health care: issues and observations

2009-08-19

T.C.M. Joosten , Inge Bongers , R.T.J.M. Janssen

BackgroundIncidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often … BackgroundIncidents and quality problems are a prime cause why health care leaders are calling to redesign health care delivery. One of the concepts used is lean thinking. Yet, lean often leads to resistance. Also, there is a lack of high quality evidence supporting lean premises. In this paper, we present an overview of lean thinking and its application to health care.

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Ten challenges in improving quality in healthcare: lessons from the Health Foundation's programme evaluations and relevant literature: Table 1

2012-04-28

Mary Dixon‐Woods , Sarah McNicol , Graham Martin

Background Formal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors aimed to … Background Formal evaluations of programmes are an important source of learning about the challenges faced in improving quality in healthcare and how they can be addressed. The authors aimed to integrate lessons from evaluations of the Health Foundation's improvement programmes with relevant literature. Methods The authors analysed evaluation reports relating to five Health Foundation improvement programmes using a form of ‘best fit’ synthesis, where a pre-existing framework was used for initial coding and then updated in response to the emerging analysis. A rapid narrative review of relevant literature was also undertaken. Results The authors identified ten key challenges: convincing people that there is a problem that is relevant to them; convincing them that the solution chosen is the right one; getting data collection and monitoring systems right; excess ambitions and ‘projectness’; organisational cultures, capacities and contexts; tribalism and lack of staff engagement; leadership; incentivising participation and ‘hard edges’; securing sustainability; and risk of unintended consequences. The authors identified a range of tactics that may be used to respond to these challenges. Discussion Securing improvement may be hard and slow and faces many challenges. Formal evaluations assist in recognising the nature of these challenges and help in addressing them.

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Implementing culture change in health care: theory and practice

2003-03-01

Tim Scott , Russell Mannion , Huw Davies +1 more

Objectives. To review some of the key debates relating to the nature of organizational culture and culture change in health care organizations and systems. Objectives. To review some of the key debates relating to the nature of organizational culture and culture change in health care organizations and systems.

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Organisational culture and quality of health care

2000-06-01

Huw Davies

A student of management and organisation theory could only be stunned by how little A student of management and organisation theory could only be stunned by how little

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Health sector accreditation research: a systematic review

2008-03-12

David Greenfield , Jeffrey Braithwaite

The purpose of this study was to identify and analyze research into accreditation and accreditation processes. A multi-method, systematic review of the accreditation literature was conducted from March to May … The purpose of this study was to identify and analyze research into accreditation and accreditation processes. A multi-method, systematic review of the accreditation literature was conducted from March to May 2007. The search identified articles researching accreditation. Discussion or commentary pieces were excluded. From the initial identification of over 3000 abstracts, 66 studies that met the search criteria by empirically examining accreditation were selected. The 66 studies were retrieved and analyzed. The results, examining the impact or effectiveness of accreditation, were classified into 10 categories: professions' attitudes to accreditation, promote change, organizational impact, financial impact, quality measures, program assessment, consumer views or patient satisfaction, public disclosure, professional development and surveyor issues. The analysis reveals a complex picture. In two categories consistent findings were recorded: promote change and professional development. Inconsistent findings were identified in five categories: professions' attitudes to accreditation, organizational impact, financial impact, quality measures and program assessment. The remaining three categories—consumer views or patient satisfaction, public disclosure and surveyor issues—did not have sufficient studies to draw any conclusion. The search identified a number of national health care accreditation organizations engaged in research activities. The health care accreditation industry appears to be purposefully moving towards constructing the evidence to ground our understanding of accreditation.

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SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): revised publication guidelines from a detailed consensus process

2015-09-14

Greg Ogrinc , Louise Davies , Daisy Goodman +3 more

Since the publication of Standards for QUality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development … Since the publication of Standards for QUality Improvement Reporting Excellence (SQUIRE 1.0) guidelines in 2008, the science of the field has advanced considerably. In this manuscript, we describe the development of SQUIRE 2.0 and its key components. We undertook the revision between 2012 and 2015 using (1) semistructured interviews and focus groups to evaluate SQUIRE 1.0 plus feedback from an international steering group, (2) two face-to-face consensus meetings to develop interim drafts and (3) pilot testing with authors and a public comment period. SQUIRE 2.0 emphasises the reporting of three key components of systematic efforts to improve the quality, value and safety of healthcare: the use of formal and informal theory in planning, implementing and evaluating improvement work; the context in which the work is done and the study of the intervention(s). SQUIRE 2.0 is intended for reporting the range of methods used to improve healthcare, recognising that they can be complex and multidimensional. It provides common ground to share these discoveries in the scholarly literature ( http://www.squire-statement.org ).

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Book Review

2000-09-01

Andrew Wall

The language of quality is getting rather dog-eared: all those assurances and all those apologies. Now, the Government are making the most of clinical mistakes in order to bring doctors … The language of quality is getting rather dog-eared: all those assurances and all those apologies. Now, the Government are making the most of clinical mistakes in order to bring doctors to heel: perhaps not a very wise policy in the long term. Whatever the motives, the long-suffering public would like to have their faith in the NHS restored.

Crossing the quality chasm: implications for health services administration education.

2004-01-01

Bernard J. Horak , William E. Welton , Stephen M. Shortell

Programs in Health Services Administration (HSA) should respond to the mandate to improve patient care as put forth by the Institute of Medicine (IOM) and other reports on the proliferation … Programs in Health Services Administration (HSA) should respond to the mandate to improve patient care as put forth by the Institute of Medicine (IOM) and other reports on the proliferation and consequences of medical errors. This article will identify a framework to base curriculum change, competency areas, and educational methods to impart quality improvement knowledge and skills. The first six competency areas reflect the six redesign imperatives from the IOM report, Crossing the Quality Chasm: A New Health System for the 21st Century (2001): redesign of the care process; use of information technologies; knowledge and skills management; development of effective teams; coordination of care; and use of performance and outcomes measurement. Based on a literature review, five additional areas were identified: strategic quality planning; programs for patient safety and risk management; change management; roles of stakeholders, payers and regulators; and development of a learning environment and blame-free culture. Examples of curriculum content are provided from HSA programs at Georgetown University, University of Washington, and University of California at Berkeley.

Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review

2019-05-29

Winnie Thembisile Maphumulo , Busisiwe Bhengu

Background: There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care … Background: There is overwhelming evidence that the quality of health care in South Africa has been compromised by various challenges that impact negatively on healthcare quality. Improvement in quality care means fewer errors, reduced delays in care delivery, improvement in efficiency, increased market share and lower cost. Decline in quality health care has caused the public to lose trust in the healthcare system in South Africa. Objectives: The purpose of this study was to identify challenges that are being incurred in practice that compromise quality in the healthcare sector, including strategies employed by government to improve the quality of health delivery. Method: Literature search included the following computer-assisted databases and bibliographies: Medline (Medical Literature Online), EBSCOhost, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google, Google Scholar and ScienceDirect. Furthermore, websites were used to source policy documents of organisations such as the National Department of Health in South Africa and the World Health Organization. Results: Seventy-four articles were selected from 1366 retrieved. These articles quantify problems facing quality care delivery and strategies used to improve the healthcare system in South Africa. Conclusion: The findings revealed that there were many quality improvement programmes that had been initiated, adapted, modified and then tested but did not produce the required level of quality service delivery as desired. As a result, the Government of South Africa has a challenge to ensure that implementation of National Core Standards will deliver the desired health outcomes, because achieving a lasting quality improvement system in health care seems to be an arduous challenge.

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Diagnosis related groups in Europe: moving towards transparency, efficiency, and quality in hospitals?

2013-06-07

Reinhard Busse , Alexander Geißler , A. Aaviksoo +7 more

Hospitals in most European countries are paid on the basis of diagnosis related groups. Reinhard Busse and colleagues find much variation within and between systems and argue that they could … Hospitals in most European countries are paid on the basis of diagnosis related groups. Reinhard Busse and colleagues find much variation within and between systems and argue that they could be improved if countries learnt from each other

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Quality in Australian Health Care Study

1996-06-01

R. M. Wilson , W. B. Runciman , Robert Gibberd +2 more

Making It Safe: The Effects of Leader Inclusiveness and Professional Status on Psychological Safety and Improvement Efforts in Health Care Teams

2009-01-01

Ingrid M. Nembhard , Amy C. Edmondson

The Accreditation Journey for a Hospital in the Developing World

2025-06-25

Hang T.T. Nguyen , Gail H. Vance , Lewis Hassell +4 more | Archives of Pathology & Laboratory Medicine

Vinmec Times City International Hospital is the first organization in Vietnam to receive certification from both the College of American Pathologists (CAP) Laboratory Accreditation Program (LAP) and Joint Commission International, … Vinmec Times City International Hospital is the first organization in Vietnam to receive certification from both the College of American Pathologists (CAP) Laboratory Accreditation Program (LAP) and Joint Commission International, marking a significant turning point in Vietnam’s approach to health care quality control. This article shares our journey toward CAP accreditation, offering insights from a laboratory in a developing nation. The data sources include documentation of our laboratory’s experiences during 2 years (2020–2022), illustrating the collaborative work and achievements in preparing for the first inspection of the CAP LAP, alongside prior discussions and commitments (2018–2020) to develop our plan. By working as a cohesive team of pathologists and staff, with a well-thought-out plan and strong support from the hospital’s executive leadership and administrative team, Vinmec Times City International Hospital in Hanoi was able to take the initial steps toward achieving and maintaining an international standard in laboratory quality management.

My accident or yours?

2025-06-24

Kristina Dahlin , Joel A. C. Baum | Oxford University Press eBooks

Abstract We distinguish learning from infrequent failures from learning from frequent successes, and identify four pathways for organizational learning from failures: (1) internal analysis of an organization’s own accidents; (2) … Abstract We distinguish learning from infrequent failures from learning from frequent successes, and identify four pathways for organizational learning from failures: (1) internal analysis of an organization’s own accidents; (2) imitation of other organizations’ responses to their accidents; (3) adoption of recommendations resulting from analyses by third-party agencies of specific accident’s causes; and (4) regulatory interventions resulting from analyses by third-party agencies of system-wide accident patterns. Using data from the US freight railroad industry between 1975 and 2001 we find that railroads learn more from others’ accidents than from their own, from third-party recommendations than analyses, and that learning from others is mediated by third-party recommendations and regulatory interventions. We conclude that third-party repositories of experience are key enablers of learning from failure. Simply put, failures are too important to leave for organizations to learn from on their own.

Selection and appointment of presidents of medical universities in Iran: Bridging reality and ideal through global and local evidence

2025-06-24

Leila Doshmangir , Mohammadhossein Somi , Sh. Lak +5 more | PLoS ONE

Background The selection of university presidents who oversee health systems within their respective provinces has become increasingly critical in Iran, subjecting to an ongoing scrutiny and debate. This study aims … Background The selection of university presidents who oversee health systems within their respective provinces has become increasingly critical in Iran, subjecting to an ongoing scrutiny and debate. This study aims to clarify the selection process and identify the essential competencies required for appointing medical university presidents both in Iran and globally, while also proposing relevant policy recommendations. Methods This study employed a multi-method approach, incorporating a scoping review, document review, interviews, and brainstorming. The scoping review, conducted in September 2024, searching databases including PubMed, ISI Web of Knowledge, and Scopus. Interviews conducted from September 2024 to November 2024, were carried out with stakeholders from a diverse range, including university presidents, health ministers, healthcare managers, decision-makers, faculty members and key planners within the academic sector, whom were selected using purposive sampling method with maximum variation. A question guide was used, the main question of which included: essential characteristics and competencies of university president, prioritized criteria for decision making, feasibility of evidence-based decision-making, the process of selecting and appointing university presidents, and the strengths and weaknesses of this process. The data were analyzed using a framework analysis approach, informed by Modified Henry Mintzberg’s Management Model and a model of policy competency. Documents related to the selection and appointment of medical university presidents, including rules, regulations, and circulars, were collected through a census approach using both manual and electronic methods. Relevant documents were systematically retrieved from the official websites of the involved organizations. Brainstorming conducted in December 2024 and was used to develop policy recommendations. Results Twenty six articles and 19 university protocols were included in the scoping review phase. Forty-two participants included in the qualitative phase of this study, most of who were president of a university. Also, 12 participants involved in the brainstorming phase. The responsibilities of a university president necessitating a blend of personal, interpersonal, professional and decisional competencies. In Iran, various factors including political preferences, lack of transparency and accountability, limited involvement from the university community, and insufficient emphasis on professional or technical competencies, influence the selection process of university presidents. The influence of some pressure groups including parliament representatives and the prevailing ideological climate within the Ministry of Health have varied across different governments, relegating essential professional competencies, such as the scientific credibility of the president, to low priority. Conclusions During various selection and appointment periods, political changes and pressure groups’ interests have had a significant impact on the management changes in universities, and with governments’ changes, managerial capabilities are overshadowed by political tendencies. This study’s findings underscore the importance of transparency, evidence-based decision-making, and a systematic approach to the selection and appointment of presidents of medical universities. Implementing these insights can enhance the integrity of the selection process and improve governance in medical education in Iran.

NHS needs managers and leaders: a brief report from the Faculty of Medical Leadership and Management conference 2024

2025-06-24

Daniel Jones , Hannah Son , Zoë Howard | BMJ Leader

Introduction Effective management and leadership are needed for the successful running and improvement of National Health Service (NHS) organisations and enhance the ability of these organisations to improve. However, NHS … Introduction Effective management and leadership are needed for the successful running and improvement of National Health Service (NHS) organisations and enhance the ability of these organisations to improve. However, NHS managers are often undervalued, and there are serious shortfalls in management capacity. We hosted a workshop with a diverse audience of health professionals, to explore this issue in depth. Description The workshop took place at the annual Faculty of Medical Leadership & Management conference 2024 with five panellists and roughly 40 delegates, lasting for over 90 minutes. It consisted of individual presentations, panel discussions, questions and answers and online polling and commentary. The results were analysed using thematic analysis. Discussion We identified four themes. The first included an overall lack of management capacity in the NHS, with fewer managers compared with other sectors and countries. Difficulties in interprofessional relationships was a second theme, for example, the lack of understanding or appreciation for the management role. Significant variation in development, training and career opportunities was the third theme. Discussions on potential regulation for NHS managers was the final theme. Conclusion The workshop report identified important challenges affecting managers and leaders in the NHS. Addressing these will be crucial to sustaining and improving high-quality care.

Doctors back GPs who refuse to follow “ludicrous and unsafe” hospital prescribing practices

2025-06-24

Rebecca Coombes | BMJ

NHS management reform: regulation is just the beginning

2025-06-20

Judith Smith , Suzie Bailey , Chris Ham | BMJ

Impact of joint commission international accreditation on occupational health and patient safety: A systematic review

2025-06-17

Anni Vuohijoki , Leena Ristolainen , Juhana Leppilahti +2 more | PLoS ONE

Objectives To illuminate the benefits of Joint Commission International (JCI) accreditation and other experiences related to the accreditation process in relation to occupational health and patient safety. Design Systematic review … Objectives To illuminate the benefits of Joint Commission International (JCI) accreditation and other experiences related to the accreditation process in relation to occupational health and patient safety. Design Systematic review Methods We systematically searched CINAHL (n = 77), ProQuest (n = 69), PsycINFO (n = 13), PubMed (n = 166), and Scopus (n = 211) for articles on JCI accreditation published until December 2023. Overall, 290 articles were found. JCI-accredited hospitals with before–after accreditation follow-up processes, hospitals during the accreditation process, and job satisfaction and/or patient safety as the primary outcome measures were included. Non-original articles, articles including non-accredited hospitals, hospitals missing before–after accreditation changes, studies with no follow-up time, hospitals implementing accreditation guidelines but not accredited, non-English publications, reviews, meta-analyses, master theses, and poor-quality studies were excluded. Results Two authors independently applied the above criteria, following which 16 articles were analyzed. Two of these, however, were further excluded due to poor quality; 14 articles were finally included. All the articles were extremely heterogeneous, leaving no possibility for a meta-analysis. Conclusions The impacts of accreditation are significant in underdeveloped than in developed nations where the legal requirements are high. Concerns regarding costs and workload associated with accreditation processes are increasing. Moreover, studies regarding JCI accreditation and its impact on occupational health or patient safety are limited, thus warranting further investigations. PROSPERO registration number: CRD42021275665.

Knowledge Gaps in Billing and Documentation Following the 2023 Evaluation and Management Services Guideline Changes

2025-06-16

Maxwell L. Howell , Jacob Kirkland , Rebecca Kernen +3 more | Western Journal of Emergency Medicine

PATIENT-CENTRED LEADERSHIP IN HOSPITAL MANAGEMENT: ETHICAL RESPONSIBILITY AND STRATEGIC ROLES OF HEALTHCARE PROFESSIONALS

2025-06-16

M. Ya. Kichula , B. M. PALASIUK , V. M. KICHULA | Вісник соціальної гігієни та організації охорони здоров я України

Purpose: to analyze the evolving role of medical professional leaders, particularly doctors and nurses, in hospital management. Materials and methods. The study used general scientific and special research methods: theoretical … Purpose: to analyze the evolving role of medical professional leaders, particularly doctors and nurses, in hospital management. Materials and methods. The study used general scientific and special research methods: theoretical generalisation, comparative analysis, classification and grouping, statistical comparison and generalization. Results. The article highlights how managers are increasingly taking on leadership and administrative responsibilities traditionally handled by non-medical staff. The article explores the ethical responsibilities, strategic roles, and management functions of healthcare leaders, emphasizing their influence on patient outcomes, hospital efficiency, quality management, cost control, and organizational culture, ethical responsibility. It underscores the need for medical leaders to develop competencies beyond clinical expertise, including skills in leadership, economics, and risk management, to ensure high-quality patient-centerd care and effective hospital operations. Conclusions. Doctors and nurses are now playing a dual role in hospitals, balancing both medical and managerial responsibilities. Their impact extends beyond patient care to include quality improvement, cost management, and shaping the hospital’s organizational culture. To succeed in these roles, they must develop skills in leadership, finance, and risk management. However, despite these expanded duties, their primary commitment should always be to providing highquality treatment and achieving the best possible outcomes for patients.

International Trends in Accreditation and Quality Assurance: Challenging Possibilities

2025-06-16

Gerardo L. Blanco , Andrés Bernasconi | International Higher Education

Achieving Joint Commission International Accreditation in War Times: Challenges Towards Excellence

2025-06-11

Carla Sawan | Journal of Health Statistics Reports

This article describes the process of achieving Joint Commission International (JCI) accreditation at a 300-bed academic medical center in Beirut, Lebanon, during a period of severe national crisis and namely … This article describes the process of achieving Joint Commission International (JCI) accreditation at a 300-bed academic medical center in Beirut, Lebanon, during a period of severe national crisis and namely the 2024 war.

The Quality of Providing Dental Services in the School of Dentistry and Private Clinics in Shiraz, Based on the SERVQUAL Model.

2025-06-01

Maryam Bakhtiar , Mohsen Sharif Zadeh Ardakani , Mohammad Reza Mokarram +2 more | PubMed

The quality of dental services is an important factor in patient satisfaction and health outcomes. However, there is a lack of studies, which compare the quality of dental services provided … The quality of dental services is an important factor in patient satisfaction and health outcomes. However, there is a lack of studies, which compare the quality of dental services provided in different settings such as dental schools and private clinics and measure the gap between patients' expectations and perceptions. This study aims to assess and compare the quality of dental services in Shiraz Dental School and private clinics using the SERVQUAL model and identify the dimensions that affect patient satisfaction. In this cross-sectional descriptive study, 440 patients of the Shiraz dental school and private clinics in Shiraz participated in answering the SERVQUAL questionnaire to measure the perceptions and expectations of patients in six dimensions (tangibility, reliability, responsiveness, assurance, empathy, and access). The mean gap score was (-1.27±0.59) for private clinics and (-0.40±0.45) for dental school, which was significant (p< 0.001) between expectations and perceptions in all dimensions in both settings. In private clinics, the largest gap was in the empathy dimension (-1.64±0.65) and the smallest gap was in the assurance dimension (-1.05±0.64). In the Shiraz dental school, the largest gap was in the tangibility dimension (-0.72±0.60) and the smallest gap was in the assurance dimension (-0.59±0.65). The patients were satisfied with the services provided in the Shiraz dental school and private clinics of Shiraz, but the expectations of the patients were not met in all dimensions, which require periodic evaluations along with policies to respond to the needs and expectations of the patients in providing services in both sectors.

Implementing a leadership system to drive change in a community-based healthcare organisation

2025-06-01

John B. Chessare , Carolyn L. Candiello , Lisa Groff-Reuschling | Management in healthcare.

Healthcare organisations are people-intensive, complex systems. Traditionally, effective leadership required the leader to possess and develop skills and competencies; however, these alone are insufficient to generate aligned and sustained change. … Healthcare organisations are people-intensive, complex systems. Traditionally, effective leadership required the leader to possess and develop skills and competencies; however, these alone are insufficient to generate aligned and sustained change. A standardised and systematic leadership approach, aligned with strategy, can help leaders move from reactive daily problem-solving to a culture of learning, improvement and innovation. Utilising the Baldrige Framework for Excellence, GBMC HealthCare developed and implemented a formalised Leadership System that is grounded in the organisation’s mission, vision and values. It considers stakeholder requirements and provides a stepwise standard approach for setting direction, building commitment, action planning, achieving results and developing people. Each step of the Leadership System has associated competencies that are used to foster development and growth. This approach was deployed across the GBMC HealthCare System, a community-based continuum of care organisation that includes an acute care hospital, a large hospice and elder care company and an ambulatory and specialty care provider group. Through case study, this paper details the framework and steps taken to develop and deploy a Leadership System that has led to sustained clinical and operational improvement. GBMC achieved the Baldrige Award in 2020, the nation’s highest presidential honour for performance excellence. In 2019, the Leadership System was recognised by Baldrige as a national best practice. Organisations can easily adopt this low-cost, high-impact method to create a standardised approach to help leaders achieve excellence both in their day-to-day activities and in guiding long-term strategic results. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/

The Themes Have to Be Considered in the Change Process Within Healthcare Organizations: Critical Analysis Review

2025-06-01

Hatem H. Alsaqqa | Journal of Multidisciplinary Healthcare

This review is intended to scrutinize different articles' types and determine a suitable process, model or framework for successful change in healthcare organizations. An integrative review of the literature was … This review is intended to scrutinize different articles' types and determine a suitable process, model or framework for successful change in healthcare organizations. An integrative review of the literature was conducted. The search strategy began with three electronic databases (EBSCOhost, Google Scholar and PubMed). Considering the inclusion criteria, published articles that examined the change process within the healthcare organizations in the timeframe between 2000 and 2023 were chosen. Results extraction and analysis were completed on all the included articles. The final sample for this review comprised 19 studies. Based on common meanings and vital issues, 8 main themes contributing to change in healthcare organizations were integrated and grouped into four main categories (process dimensions), two adjunct factors (strategic dimensions) and one mediating tool and a result category. The four main categories are readiness to change, team-building, tangible and intangible variables' characteristics and the two adjunct factors are the metaphor design and time perspective. In addition to technology as a mediating role for change and the scale of the change as a resulted outcome. In general, collections that emerged in this study could be useful for framing initiatives to arouse organizational change in healthcare. However, little is known about the relative significance of each acknowledged factor within the change process in healthcare organizations. Various methodological research is recommended for narrowing this gap. Before beginning the change process, ongoing studies should focus on the psychological features of organizational scales for healthcare contexts.

Audit of Local Clinical Governance in London & South Region – 2025

2025-06-01

Gayathri Rangith , Arokia Antonysamy | BJPsych Open

Aims: Clinical governance ensures accountability for continuously improving healthcare quality. This audit evaluates governance compliance across hospital sites in the London & South region, highlighting best practices and opportunities for … Aims: Clinical governance ensures accountability for continuously improving healthcare quality. This audit evaluates governance compliance across hospital sites in the London & South region, highlighting best practices and opportunities for improvement to enhance patient safety, care standards, and clinical effectiveness. Aims were to: Identify good clinical governance practices across hospitals to enable peer learning, knowledge sharing and implementation of best practices. Support continuous improvement by implementing lessons learned from top-performing sites. Methods: Data was collected from Local Clinical Governance meeting minutes (September–December 2024) across multiple hospital sites. Key assessment areas included: Meeting frequency and leadership involvement. Attendance and representation from MDT and Operations. Adherence to governance agenda. Safety. Training. Clinical effectiveness. Experience. Leadership. Audit and research. Lessons learned. Standards applied: National Standards on Clinical Audit – NHS England Clinical Governance Framework (2022); Local Clinical governance standards including the STEELL agenda (Safety, Training, Effectiveness, Experience, Leadership, Lessons Learned). Results: Key findings: Safety and Incident Reporting: Enhanced training programmes contributed to a decline in incidents, across different service lines including Acute, PICU, Rehabilitation, Learning disability and personality disorder units. Patient and Carer Experience: Positive patient experience achieved with least restrictive practices and removing blanket restrictions with structured feedback from patient councils, advocacy services and Experts by Experience (EbyE). Clinical Effectiveness and Governance: Higher compliance in care plans and activity programmes were noted in wards with good training and supervision and adherence to clinical models of care Staffing and Workforce Development: Recruitment strategies helped fill critical vacancies in nursing, psychology, and occupational therapy, ensuring consistent service provision. Patient Engagement and Activities: Structured activity programmes led to better engagement, particularly where collaborative interdisciplinary teams facilitated therapeutic and skill-based activities. Areas for Improvement: Standardisation of digital tracking for patient engagement to ensure accurate compliance data. Increased MDT participation in governance meetings for enhanced multidisciplinary oversight. Conclusion: Recommendations: Standardise incident reporting and documentation protocols. Enhance security for AWOL risk and contraband prevention. Ensure hospitals share their best practices with the wider group. Conclusion: This audit highlights significant progress in governance, patient engagement, and structured safety interventions across multiple hospital sites. By implementing targeted improvements in data tracking, workforce development, and interdisciplinary collaboration, hospitals can achieve greater compliance, patient-centred care, and long-term service effectiveness. A follow-up audit will assess the impact of these interventions on clinical outcomes and governance excellence.

Diagnostic and therapeutic quality and management capacity for coronary heart disease in Shanghai community medical institutions: a cross-sectional study

2025-05-29

Yang Sen , He Liuhua , Jiaojiao Wang +7 more | Research Square (Research Square)

<title>Abstract</title> <bold>Background </bold>Coronary heart disease (CHD) remains one of the leading causes of death worldwide. However, systematic evaluations of CHD management quality at the community level remain limited, thereby constraining … <title>Abstract</title> <bold>Background </bold>Coronary heart disease (CHD) remains one of the leading causes of death worldwide. However, systematic evaluations of CHD management quality at the community level remain limited, thereby constraining improvements in primary medical capacity.<bold> This study aims to evaluate community-based CHD management using Donabedian's model to optimize resource allocation, standardize clinical pathways, and improve chronic disease management.</bold> <bold>Methods </bold>Guided by Donabedian's model, this study assessed the quality of CHD diagnosis and management within Shanghai's primary healthcare system across three dimensions—structure, process, and outcome—from the dual perspectives of community healthcare institutions and general practitioners (GPs). A cross-sectional survey was conducted between April and May 2024, involving 247 primary healthcare institutions selected through census sampling. Within each administrative district, 50% of institutions were randomly selected using cluster sampling. Subsequently, stratified sampling based on professional titles was employed to survey 50% of GPs within these institutions. In total, 247 institutional questionnaires and 2,093 GPs' responses were deemed valid and included in the final analysis. <bold>Results </bold>Structural analysis indicated adequate CHD-specialized clinics (74.8% with integrated care teams) and essential equipment availability (>97%), but major gaps in rehabilitation resources (personnel: 14.6%; equipment: 8.5%). Process evaluation showed high referral rates (91.5%) yet poor patient self-management (18.6%) and limited health record completeness (27.1%). Only 26.7% of institutions adopted CHD-specific information systems. GPs demonstrated strong acute care capacity but had knowledge gaps in advanced concepts (53.6%) and test interpretation (45.4%). Key barriers included equipment shortages (75.5%) and protocol adherence issues (73.1%), with prioritized solutions emphasizing medical consortium collaboration (89.4%) and multidisciplinary team development (88.3%). <bold>Conclusion</bold>CHD management in Shanghai's community settings is marked by adequate provision of essential resources but notable deficiencies in rehabilitation services and digital infrastructure. Strengthening rehabilitation services, enhancing information system development, and providing targeted training to improve diagnostic and management capacities are recommended. These findings may provide valuable insights for informing similar efforts in other regions.

Leading with Love: An Evidence-Informed Framework for Leading Health System Transformation

2025-05-29

Patrick Runnels , Peter J. Pronovost | Population Health Management

A brief history of discharge summaries . . . and other research

2025-05-29

Tom Nolan | BMJ

Accreditation of surgery residency training programs in a state teaching hospital: preparedness, areas of strengths and weaknesses

2025-05-28

Linda Iroegbu-Emeruem , Rex Friday Ogoronte A. Ijah , Idawarifagha Hart +4 more | International Surgery Journal

Background: Quality assurance is a critical issue in almost every aspect of human society, including the health sector. This study evaluated the preparedness, strengths and weaknesses associated with accreditation of … Background: Quality assurance is a critical issue in almost every aspect of human society, including the health sector. This study evaluated the preparedness, strengths and weaknesses associated with accreditation of the Surgery Department of the Rivers State University Teaching Hospital for the training programs of the West African College of Surgeons. Methods: A prospective observational study was carried out among team leads of the accreditation sub-committees in the year 2024, using a proforma. Data was presented as percentages and tables. Results: There were multi-level accreditation committees and sub-committees that worked for the success of the accreditation. The requirements and scores improved with consecutive phase of evaluation. Surgical and anaesthesia manpower, radiologic services, operating theatre, intensive care unit, physiotherapy services, resident doctors’ welfare and utilities all had 80% and above. Consultants’ welfare met 50% requirement, while others were between 50%-80%. Conclusions: Manpower, facilities, utilities and environment of practice, some surgical support services and residents’ welfare, were areas of strength. Improvement in consultants’ welfare and software programs that drive residency training is highly recommended in preparation for subsequent accreditations visits.

The impact of clinical pathway teaching combined with objective structural clinical examination (OSCE) on nursing performance and clinical competence of new ICU nurses: a quasi-experimental study

2025-05-27

Yingying Gao , Xiaorong Ding , Jiaqing Xu +4 more

Due to the theory-practice gap, new ICU nurses often struggle to manage critically ill patients and high-risk conditions. While structured training programs exist, they lack standardized content and implementation path. … Due to the theory-practice gap, new ICU nurses often struggle to manage critically ill patients and high-risk conditions. While structured training programs exist, they lack standardized content and implementation path. This study aims to explore the impact of clinical pathway teaching combined with OSCE on new ICU nurses' nursing performance and clinical competence. Used sampling, a quasi-experimental with non-randomized two-group study design. We selected new nurses (n = 52) who joined their ICU from August 2020 to January 2022 and divided the subjects chronologically into two groups. The experimental group used clinical pathway teaching combined with the OSCE evaluation, while the control group took the routine method. We used the six-dimension scale of nursing performance scale (6-D) and the Nursing Clinical Competence Questionnaire (CNCQ) to collect the new ICU nurses' data before and after a two-month training cycle. Statistical analysis was performed using t-tests and χ2-test, with a significance level set at P < 0.05. After training, the nurses of the experimental group had higher scores on the Nursing Clinical Competence Questionnaire (93.46 ± 11.20) compared to the control group (85.92 ± 12.19), and this difference was significant (P < 0.05). The nurses of the experimental group had lower scores on the 6-D scale before training (154.19 ± 38.32) compared to the control group (187.15 ± 32.20), the difference was significant(P < 0.05), but there was no significant difference after training (P>0.05). Clinical pathway teaching combined with OSCE improve the clinical competence of new ICU nurses, and promote nursing performance. However, job experience and clinical environment might influence nursing performance.

The compliance of the training program for hospital accreditation surveyors in Iran with the international requirements: a mixed-methods study

2025-05-27

Tahmineh Poursaki , Lida Shams , Ali Maher +1 more

Balancing autonomy and accountability in national public hospitals – a qualitative case study

2025-05-27

Margit Malmmose , Jakob Mathias Liboriussen | Accounting Forum

Strategizing towards the future hospital: a systems thinking approach

2025-05-27

Ashish Kumar , Shao Wei Lam , Sze Ling Chan +4 more

3 Form, Function, and Productivity at the Hospital

2025-05-24

37 Lean On: Planning For, Insisting On, and Accepting Support

2025-05-24

Sara Bartlett Large

Implementing quality and safety regulations in residential disability services: a qualitative interview study

2025-05-24

Paul Dunbar , Laura M. Keyes , John Browne

Background Regulation plays a central role in health and social care systems, particularly in ensuring quality, safety and accountability. However, there is limited understanding of how organisations effectively implement and … Background Regulation plays a central role in health and social care systems, particularly in ensuring quality, safety and accountability. However, there is limited understanding of how organisations effectively implement and adhere to these regulatory requirements. In particular, little is known about how providers of residential care facilities for people with disabilities (RCF-D) navigate and apply statutory care regulations. Methods We conducted semistructured interviews with managers of RCF-D. Participant recruitment followed a purposive maximum variation sampling approach. 19 participants were interviewed, representing 22 RCF-D and 16 provider organisations. Interview data were analysed using a mixed deductive–inductive approach. Results Most managers were supportive of regulatory goals, creating a more favourable environment for successful implementation. By making sense of regulatory requirements and sharing insights across their organisations, managers facilitated smoother implementation. Crucially, building strong internal and external networks played a pivotal role in driving success. Collaborative relationships with inspectors, centred on a shared commitment to improving residents’ lives, further strengthened the implementation process. Conclusion Managers of RCF-D devised a range of strategies to manage compliance, balancing regulatory demands with problem-solving and relationship-building. These efforts were supported by a collaborative approach to working with inspectors, which fostered a shared commitment to improving residents’ lives. Our findings offer practical guidance for organisations seeking to improve regulatory compliance through effective relationship management and resource alignment. Future research could investigate how framing regulation as an adaptive intervention could further enhance implementation and sustain compliance.

Knowledge, attitudes, and practices among central sterile supply department staff in ministry of defense hospitals in the eastern province of Saudi Arabia: A cross-sectional study

2025-05-22

Awatef Mohammed Al-Balawi , Diaa Almutairi

This study evaluated the knowledge, attitudes, and practices (KAP) of Central Sterile Supply Department (CSSD) staff at Ministry of Defence hospitals in the Eastern Province of Saudi Arabia regarding sterilization … This study evaluated the knowledge, attitudes, and practices (KAP) of Central Sterile Supply Department (CSSD) staff at Ministry of Defence hospitals in the Eastern Province of Saudi Arabia regarding sterilization protocols. A cross-sectional study was conducted using a self-administered online questionnaire distributed to 54 CSSD staff members. The questionnaire assessed demographic characteristics, knowledge, attitudes, and practices related to sterilization. KAP scores were categorized as poor, moderate, or good. Results: The findings indicated that 57.4% of participants had adequate knowledge, 55.6% adhered to good sterilization practices, and 24.1% displayed a positive attitude toward sterilization. A positive correlation was found between knowledge and attitude (rs=0.348, p=0.010) and practice scores (rs=0.302, p=0.027). However, some knowledge gaps were identified in areas such as spill kit use and the distinction between scopes. While the majority of CSSD staff demonstrated adequate knowledge and practice, there is a need for targeted training to address knowledge gaps and improve attitudes, particularly regarding specific sterilization practices. Hospitals should prioritize continuous education and targeted training programs for CSSD staff to enhance sterilization protocols, thereby improving infection prevention and control measures. Further research is needed across a broader range of hospitals to assess national trends.

Effect of Accreditation on Patient Safety Culture: Insights from a Brazilian Multicenter Cross-Sectional Study

2025-05-22

Helidea de Oliveira Lima , Leopoldo Muniz da Silva , Rene Coulaud Santos da Costa Cruz +5 more

ABSTRACT Introduction As healthcare organizations strive to improve the quality and safety of their services, there is growing recognition of the importance of fostering a patient safety culture to enhance … ABSTRACT Introduction As healthcare organizations strive to improve the quality and safety of their services, there is growing recognition of the importance of fostering a patient safety culture to enhance patient safety and improve patient care outcomes. This study aims to evaluate healthcare professionals’ perceptions of patient safety culture in accredited vs nonaccredited hospitals within a network of 68 hospitals in Brazil. Methods This cross-sectional, multicenter study included 68 hospitals from a private network. The Hospital Survey on Patient Safety Culture (HSOPSC) was administered across all participating hospitals in September 2022. Hospitals that had been formally recognized for their quality and safety standards were compared with nonaccredited hospitals. Scores for various dimensions of patient safety culture were compared between groups. A logistic regression model was applied to assess the association between the frequency of event reporting in the past 12 months and participant characteristics. Results A total of 31,919 healthcare professionals responded to the survey. Compared with nonaccredited hospitals, accredited hospitals reported higher scores in communication openness (3% higher, p = 0.04), frequency of events reported (4% higher, p = 0.02), and overall perception of patient safety (4% higher, p = 0.02). Accreditation was associated with a reduced likelihood of event underreporting (odds ratio = 0.80; 95% CI, 0.74–0.87), and physicians were more likely to underreport compared with nursing staff. Conclusion Although accreditation enhances patient safety culture, its effect may be more limited in healthcare networks with robust quality management systems already in place. To drive meaningful improvements, policymakers should go beyond accreditation and prioritize the reinforcement of ongoing institutional safety initiatives. Particular attention should be given to persistent challenges, such as fostering a nonpunitive approach to errors and addressing underreporting of adverse events. A graphical abstract is provided in the supplemental material.

The relationship between nurse staffing and financial performance of hospitals in Taiwan: Mediating and moderating effects of healthcare quality

2025-05-21

H H Chung , Kuan-Chen Chen , Chung-I Lin +1 more

Developing a National Accreditation Model for Medication Management in the Iranian Primary Health Care System

2025-05-21

Esmaeil Moshiri , Masoumeh Ebrahimi Tavani , Farid Gharibi

Background: Medication management plays a critical role in the quality of delivered treatments and patient safety. Objectives: The present study aimed to develop a national accreditation model for medication management … Background: Medication management plays a critical role in the quality of delivered treatments and patient safety. Objectives: The present study aimed to develop a national accreditation model for medication management within the Iranian primary health care (PHC) system. Methods: The primary standards were developed by considering existing accreditation models worldwide, reviewing available medication management documentation in Iran’s PHC system, and obtaining expert opinions in this field. The developed standards and measures were incorporated into a Delphi Questionnaire and evaluated by experts based on two criteria: Importance and feasibility, using a 9-point scale. The Delphi panel consisted of 20 experts, and the technique was implemented over two rounds. Of the 20 experts, 18 completed the questionnaire, with response rates of 90% and 100% in the first and second rounds, respectively. Results: The study was conducted in 2021 - 2022. In the first round of the Delphi process, 55 out of 65 primary measures reached a quorum and were accepted. The remaining ten measures were approved by experts in the second round. The model developed in this study comprises five main standards: “Provision of resources for activities in the field of medication management”, “development and consideration of the list of authorized medications for prescribing in the form of a pharmacopoeia”, “safety in prescription and medication use”, “ordering, storing, and dispensing systems of medications” and “educating the community about the correct use of medications”. The total mean scores for all measures in terms of importance and feasibility were 8.32 and 7.68, respectively. Conclusions: Given the high consensus among experts on the importance and feasibility of the developed standards, there is optimism that utilizing this model can lead to continuous improvement in the quality and safety of medication management in the Iranian PHC system.

Micro-credentials: What, why and whereto

2025-05-20

Flip Schutte , Truida Oosthuizen | Deleted Journal

In the rapidly evolving landscape of the modern workforce, traditional higher education models are being challenged to adapt to new types of students and the principles of lifelong learning, including … In the rapidly evolving landscape of the modern workforce, traditional higher education models are being challenged to adapt to new types of students and the principles of lifelong learning, including the need for continuous professional development. Higher Education Institutions (HEIs) have traditionally used short-learning programs (SLPs) to meet this demand. However, the recent emergence of micro-credentials in the Higher Education landscape lacks a standardised definition, leading to confusion with SLPs. This paper aims to clarify these definitions, propose criteria for distinction, and establish a unique definition for micro-credentials. Statutory bodies may not yet be prepared for undergraduate programs with open curricula and flexible electives, where students construct qualifications through a series of integrated micro-credentials. This open process requires rigorous quality assurance and structural processes. Despite the entrenched nature of current qualification frameworks, international qualification authorities will be cautious in adopting such revolutionary changes. Nevertheless, digital platforms and new technologies offer immense possibilities, making timely adaptation crucial. Micro-credentials reflect a shift towards lifelong learning, essential for career progression and adaptability. For employers, they provide a reliable means of assessing competencies, developed in collaboration with industry stakeholders to ensure relevance. For individuals, they offer a pathway to upskill or reskill without traditional degrees' significant time and financial commitments. Preliminary findings suggest that micro-credentials are more flexible and industry-aligned than traditional SLPs. Based on the literature review, we propose a clear and distinctive definition of micro-credentials, emphasising their role in enhancing employability and supporting lifelong learning. The conclusions drawn from this study underscore the need for HEIs and statutory bodies to adopt standardised frameworks and accreditation for micro-credentials to maximise their potential benefits.

Criterios y norma de acreditación en calidad para servicios de hospitalización a domicilio: documento de la Sociedad Española de Hospitalización a Domicilio y la Sociedad Española de Calidad Asistencial

2025-05-16

Miguel Rubio , José Regalado de los Cobos , L Villegas Bruguera +5 more

La ricerca delle professioni sanitarie in Piemonte

2025-05-16

Gruppo di Lavoro DAIRI-R

Questo volume realizzato dal GdL regionale DAIRI-R "La Ricerca della Professioni Sanitarie" rappresenta un importante contributo alla valorizzazione della ricerca promossa dalle Aziende Sanitarie del Piemonte, con particolare attenzione alle … Questo volume realizzato dal GdL regionale DAIRI-R "La Ricerca della Professioni Sanitarie" rappresenta un importante contributo alla valorizzazione della ricerca promossa dalle Aziende Sanitarie del Piemonte, con particolare attenzione alle Professioni Sanitarie. Attraverso la raccolta e l’analisi degli studi in corso, il Quaderno offre una panoramica aggiornata sullo stato dell’arte della ricerca applicata in ambiti quali l’efficacia degli interventi, la sicurezza del paziente, l’umanizzazione delle cure e l’ottimizzazione dei percorsi assistenziali. La pubblicazione evidenzia il ruolo centrale degli infermieri e degli altri professionisti sanitari nel produrre conoscenze scientifiche orientate al miglioramento della qualità dell’assistenza e alla promozione della salute, sviluppando una cultura professionale fondata sull’evidenza, a beneficio della comunità scientifica e dei cittadini.