Cargando…
Enacting quality improvement in ten European hospitals: a dualities approach
BACKGROUND: Hospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364540/ https://www.ncbi.nlm.nih.gov/pubmed/32678008 http://dx.doi.org/10.1186/s12913-020-05488-9 |
_version_ | 1783559850141155328 |
---|---|
author | Nunes, Francisco G. Robert, Glenn Weggelaar-Jansen, Anne Marie Wiig, Siri Aase, Karina Karltun, Anette Fulop, Naomi J. |
author_facet | Nunes, Francisco G. Robert, Glenn Weggelaar-Jansen, Anne Marie Wiig, Siri Aase, Karina Karltun, Anette Fulop, Naomi J. |
author_sort | Nunes, Francisco G. |
collection | PubMed |
description | BACKGROUND: Hospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions inherent to hospitals’ quest for improved quality, this article aims to identify which organizational dualities managers should particularly pay attention to. METHODS: A set of cross-national, multi-level case studies was conducted involving 383 semi-structured interviews and 803 h of non-participant observation of key meetings and shadowing of staff in ten purposively sampled hospitals in five European countries (England, the Netherlands, Portugal, Sweden, and Norway). RESULTS: Six dualities that describe the quest for improved quality, each embracing a seemingly contradictory feature were identified: plural consensus, distributed connectedness, orchestrated emergence, formalized fluidity, patient coreness, and cautious generativeness. CONCLUSIONS: We advocate for a move from the usual sequential and project-based and systemic thinking about quality improvement to the development of meta-capabilities to balance the simultaneous operation of opposing ideas or concepts. Doing so will help hospital managers to deal with major challenges of change inherent to quality improvement initiatives. |
format | Online Article Text |
id | pubmed-7364540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-73645402020-07-20 Enacting quality improvement in ten European hospitals: a dualities approach Nunes, Francisco G. Robert, Glenn Weggelaar-Jansen, Anne Marie Wiig, Siri Aase, Karina Karltun, Anette Fulop, Naomi J. BMC Health Serv Res Research Article BACKGROUND: Hospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions inherent to hospitals’ quest for improved quality, this article aims to identify which organizational dualities managers should particularly pay attention to. METHODS: A set of cross-national, multi-level case studies was conducted involving 383 semi-structured interviews and 803 h of non-participant observation of key meetings and shadowing of staff in ten purposively sampled hospitals in five European countries (England, the Netherlands, Portugal, Sweden, and Norway). RESULTS: Six dualities that describe the quest for improved quality, each embracing a seemingly contradictory feature were identified: plural consensus, distributed connectedness, orchestrated emergence, formalized fluidity, patient coreness, and cautious generativeness. CONCLUSIONS: We advocate for a move from the usual sequential and project-based and systemic thinking about quality improvement to the development of meta-capabilities to balance the simultaneous operation of opposing ideas or concepts. Doing so will help hospital managers to deal with major challenges of change inherent to quality improvement initiatives. BioMed Central 2020-07-16 /pmc/articles/PMC7364540/ /pubmed/32678008 http://dx.doi.org/10.1186/s12913-020-05488-9 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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 in a credit line to the data. |
spellingShingle | Research Article Nunes, Francisco G. Robert, Glenn Weggelaar-Jansen, Anne Marie Wiig, Siri Aase, Karina Karltun, Anette Fulop, Naomi J. Enacting quality improvement in ten European hospitals: a dualities approach |
title | Enacting quality improvement in ten European hospitals: a dualities approach |
title_full | Enacting quality improvement in ten European hospitals: a dualities approach |
title_fullStr | Enacting quality improvement in ten European hospitals: a dualities approach |
title_full_unstemmed | Enacting quality improvement in ten European hospitals: a dualities approach |
title_short | Enacting quality improvement in ten European hospitals: a dualities approach |
title_sort | enacting quality improvement in ten european hospitals: a dualities approach |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364540/ https://www.ncbi.nlm.nih.gov/pubmed/32678008 http://dx.doi.org/10.1186/s12913-020-05488-9 |
work_keys_str_mv | AT nunesfranciscog enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT robertglenn enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT weggelaarjansenannemarie enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT wiigsiri enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT aasekarina enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT karltunanette enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach AT fulopnaomij enactingqualityimprovementinteneuropeanhospitalsadualitiesapproach |