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High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement

BACKGROUND: High performing hospitals attain excellence across multiple measures of performance and multiple departments. Studying high performing hospitals can be valuable if factors associated with high performance can be identified and applied. Factors leading to high performance are complex and...

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Autores principales: Taylor, Natalie, Clay-Williams, Robyn, Hogden, Emily, Braithwaite, Jeffrey, Groene, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478709/
https://www.ncbi.nlm.nih.gov/pubmed/26104760
http://dx.doi.org/10.1186/s12913-015-0879-z
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author Taylor, Natalie
Clay-Williams, Robyn
Hogden, Emily
Braithwaite, Jeffrey
Groene, Oliver
author_facet Taylor, Natalie
Clay-Williams, Robyn
Hogden, Emily
Braithwaite, Jeffrey
Groene, Oliver
author_sort Taylor, Natalie
collection PubMed
description BACKGROUND: High performing hospitals attain excellence across multiple measures of performance and multiple departments. Studying high performing hospitals can be valuable if factors associated with high performance can be identified and applied. Factors leading to high performance are complex and an exclusive quantitative approach may fail to identify richly descriptive or relevant contextual factors. The objective of this study was to undertake a systematic review of qualitative literature to identify methods used to identify high performing hospitals, the factors associated with high performers, and practical strategies for improvement. METHODS: Methods used to collect and summarise the evidence contributing to this review followed the ‘enhancing transparency in reporting the synthesis of qualitative research’ protocol. Peer reviewed studies were identified through Medline, Embase and Cinahl (Jan 2000-Feb 2014) using specified key words, subject terms, and medical subject headings. Eligible studies required the use of a quantitative method to identify high performing hospitals, and qualitative methods or tools to identify factors associated with high performing hospitals or hospital departments. Title, abstract, and full text screening was undertaken by four reviewers, and inter-rater reliability statistics were calculated for each review phase. Risk of bias was assessed. Following data extraction, thematic syntheses identified contextual factors important for explaining success. Practical strategies for achieving high performance were then mapped against the identified themes. RESULTS: A total of 19 studies from a possible 11,428 were included in the review. A range of process, output, outcome and other indicators were used to identify high performing hospitals. Seven themes representing factors associated with high performance (and 25 sub-themes) emerged from the thematic syntheses: positive organisational culture, senior management support, effective performance monitoring, building and maintaining a proficient workforce, effective leaders across the organisation, expertise-driven practice, and interdisciplinary teamwork. Fifty six practical strategies for achieving high performance were catalogued. CONCLUSIONS: This review provides insights into methods used to identify high performing hospitals, and yields ideas about the factors important for success. It highlights the need to advance approaches for understanding what constitutes high performance and how to harness factors associated with high performance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0879-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-44787092015-06-25 High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement Taylor, Natalie Clay-Williams, Robyn Hogden, Emily Braithwaite, Jeffrey Groene, Oliver BMC Health Serv Res Research Article BACKGROUND: High performing hospitals attain excellence across multiple measures of performance and multiple departments. Studying high performing hospitals can be valuable if factors associated with high performance can be identified and applied. Factors leading to high performance are complex and an exclusive quantitative approach may fail to identify richly descriptive or relevant contextual factors. The objective of this study was to undertake a systematic review of qualitative literature to identify methods used to identify high performing hospitals, the factors associated with high performers, and practical strategies for improvement. METHODS: Methods used to collect and summarise the evidence contributing to this review followed the ‘enhancing transparency in reporting the synthesis of qualitative research’ protocol. Peer reviewed studies were identified through Medline, Embase and Cinahl (Jan 2000-Feb 2014) using specified key words, subject terms, and medical subject headings. Eligible studies required the use of a quantitative method to identify high performing hospitals, and qualitative methods or tools to identify factors associated with high performing hospitals or hospital departments. Title, abstract, and full text screening was undertaken by four reviewers, and inter-rater reliability statistics were calculated for each review phase. Risk of bias was assessed. Following data extraction, thematic syntheses identified contextual factors important for explaining success. Practical strategies for achieving high performance were then mapped against the identified themes. RESULTS: A total of 19 studies from a possible 11,428 were included in the review. A range of process, output, outcome and other indicators were used to identify high performing hospitals. Seven themes representing factors associated with high performance (and 25 sub-themes) emerged from the thematic syntheses: positive organisational culture, senior management support, effective performance monitoring, building and maintaining a proficient workforce, effective leaders across the organisation, expertise-driven practice, and interdisciplinary teamwork. Fifty six practical strategies for achieving high performance were catalogued. CONCLUSIONS: This review provides insights into methods used to identify high performing hospitals, and yields ideas about the factors important for success. It highlights the need to advance approaches for understanding what constitutes high performance and how to harness factors associated with high performance. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12913-015-0879-z) contains supplementary material, which is available to authorized users. BioMed Central 2015-06-24 /pmc/articles/PMC4478709/ /pubmed/26104760 http://dx.doi.org/10.1186/s12913-015-0879-z Text en © Taylor et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Taylor, Natalie
Clay-Williams, Robyn
Hogden, Emily
Braithwaite, Jeffrey
Groene, Oliver
High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title_full High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title_fullStr High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title_full_unstemmed High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title_short High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
title_sort high performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478709/
https://www.ncbi.nlm.nih.gov/pubmed/26104760
http://dx.doi.org/10.1186/s12913-015-0879-z
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