The impact of leadership churn on quality management in Australian hospitals

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

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

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

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

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

The impact of the implementation of management system on the perception of role and tasks of maintenance services and effectiveness of their functioning

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Przemysław Drożyner
Keyword(s):  
Quality Management ◽  
Management System ◽  
Iso 9001 ◽  
Management Systems ◽  
Important Conclusion ◽  
Repair Work ◽  
Content Type ◽  
The Impact

PurposeThe first goal of the article was to examine how the perception of the role and scope of operation of maintenance services in the enterprise changes, depending on whether the company has an integrated management system (IMS), only a quality management system implemented in accordance with ISO 9001 and in the absence of a formal, certified management system. The second goal was to propose a model for assessing the quality of maintenance service functioning in enterprise with IMS implemented.Design/methodology/approachThe author's experience of over 1,000 audits in enterprises in various industries: food, automotive, construction, petrochemical, electronic and so on was used in the work. The audits were carried out in three types of companies: which had IMSs (800 audits), which only had a system implementation certificate ISO 9001 (140 audits) and without any standardized management system implemented (so-called second-party audits, commissioned by the client of the audited company.FindingsThe most important conclusion is – the role of UR services in enterprises with the implemented IMS is much broader and goes beyond the classic framework for planning, implementation and settlement of maintenance and repair work. Maintenance is understood more broadly and includes in its scope also the safety of people and the environment, the efficiency of production and consumption of utilities as well as the quality of products and services. Maintenance issues include not only strictly technical aspects but also economic, logistic, legal and organizational and management aspects.Practical implicationsResearch shows that enterprises, especially those with high technical and organizational culture, should not treat management systems as costs, but as a driving force for the implementation of new technologies, new organizational solutions and the development of employees' competences.Social implicationsBroad views on stakeholders of maintenance services (including employees, their families, control institutions) and their requirements make enterprises begin to see the need to maintain the so-called lifetime balance, as well as the safety and comfort of work of employees of these services.Originality/valueThe author did not find in literature any reports on studies of the impact of formal, certified management systems on the quality of maintenance services; this article shows that this impact is large and, above all, positive; with such a broad understanding of the role of maintenance, there is a need to develop a common platform for such seemingly distant concepts as machine technical condition or fatigue life versus cost accounting and quality management.

Using a disease pathway management approach to improve the quality of breast cancer care in Ontario.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 109-109
Author(s):  
Andrea Eisen ◽  
Jasmin Soobrian ◽  
Ashley Tyrrell ◽  
Clement Li ◽  
Derek Muradali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Care ◽  
Performance Measurement ◽  
Quality Indicators ◽  
Cancer Care ◽  
Evidence Based ◽  
Breast Cancer Care ◽  
Patient Journey ◽  
The Impact

109 Background: Disease Pathway Management (DPM) is used by Cancer Care Ontario (CCO) to set priorities for cancer control, plan cancer services, and improve the quality of care in Ontario by promoting standardization. The DPM approach applies a framework to examine the performance of the entire system from prevention to end of life care, and to identify any gaps within the system. In 2014, DPM began its breast cancer pathway initiative by mapping the patient journey, depicting evidence-based best practice along the breast cancer care continuum, identifying where further guidance is needed for clinical decision making, and identifying gaps in quality of care and performance measurement indicators. Objective: To evaluate the impact of DPM on quality assessment of breast cancer care in Ontario. Methods: DPM convened a multidisciplinary breast cancer working group (WG) of 40 experts from across Ontario. The WG held 12 meetings and used guidelines developed by CCO’s Program in Evidence Based Care (or other sources as needed) to generate pathways for the prevention, screening and diagnosis, treatment, and follow-up care for breast cancer. The pathways were used as a framework to review the existing inventory of provincial breast cancer quality indicators, and to identify areas where evidence based guidance is needed. The pathways were subjected to an extensive review process before publication. Results: The expert WG identified 28 priority areas, including opportunities to develop guidance in areas where it is lacking (e.g. role of perioperative breast MRI; indications for contralateral prophylactic mastectomy) and system barriers that may hinder optimal care (e.g. biomarker assessment). The WG also used the pathways as a framework for evaluating performance measurement indicators by mapping 48 existing quality indicators for breast cancer to the pathway. Conclusions: The CCO DPM Breast Cancer pathways facilitated a province-wide, multidisciplinary process to promote quality standards, to identify gaps and overlaps in performance and quality measurement, and to recommend additional indicators more relevant to the quality of breast cancer care in Ontario.

Manager traits and quality-of-care performance in hospitals

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

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

scholarly journals Combined quality function deployment and logical framework analysis to improve quality of emergency care in Malta

2016 ◽  
Vol 29 (2) ◽  
pp. 123-140 ◽  
Author(s):  
Sandra Catherine Buttigieg ◽  
Prasanta Kumar Dey ◽  
Mary Rose Cassar
Keyword(s):  
Quality Improvement ◽  
Quality Of Care ◽  
Quality Management ◽  
Quality Function Deployment ◽  
Patient Flow ◽  
Healthcare Quality ◽  
Improve Quality ◽  
Logical Framework ◽  
Content Type

Purpose – The purpose of this paper is to develop an integrated patient-focused analytical framework to improve quality of care in accident and emergency (A & E) unit of a Maltese hospital. Design/methodology/approach – The study adopts a case study approach. First, a thorough literature review has been undertaken to study the various methods of healthcare quality management. Second, a healthcare quality management framework is developed using combined quality function deployment (QFD) and logical framework approach (LFA). Third, the proposed framework is applied to a Maltese hospital to demonstrate its effectiveness. The proposed framework has six steps, commencing with identifying patients’ requirements and concluding with implementing improvement projects. All the steps have been undertaken with the involvement of the concerned stakeholders in the A & E unit of the hospital. Findings – The major and related problems being faced by the hospital under study were overcrowding at A & E and shortage of beds, respectively. The combined framework ensures better A & E services and patient flow. QFD identifies and analyses the issues and challenges of A & E and LFA helps develop project plans for healthcare quality improvement. The important outcomes of implementing the proposed quality improvement programme are fewer hospital admissions, faster patient flow, expert triage and shorter waiting times at the A & E unit. Increased emergency consultant cover and faster first significant medical encounter were required to start addressing the problems effectively. Overall, the combined QFD and LFA method is effective to address quality of care in A & E unit. Practical/implications – The proposed framework can be easily integrated within any healthcare unit, as well as within entire healthcare systems, due to its flexible and user-friendly approach. It could be part of Six Sigma and other quality initiatives. Originality/value – Although QFD has been extensively deployed in healthcare setup to improve quality of care, very little has been researched on combining QFD and LFA in order to identify issues, prioritise them, derive improvement measures and implement improvement projects. Additionally, there is no research on QFD application in A & E. This paper bridges these gaps. Moreover, very little has been written on the Maltese health care system. Therefore, this study contributes demonstration of quality of emergency care in Malta.

A study of deficiencies in teamwork skills among Jordan caregivers

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

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

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

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

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

scholarly journals HRM in healthcare: the role of work engagement

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

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

Quality improvement in chronic care by self-audit, benchmarking and networking in general practices in South Tyrol, Italy: results from an interventional study

2020 ◽  
Author(s):  
Giuliano Piccoliori ◽  
Angelika Mahlknecht ◽  
Muna E Abuzahra ◽  
Adolf Engl ◽  
Vera Breitenberger ◽  
...  
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Quality Indicators ◽  
Quality Score ◽  
Interventional Study ◽  
South Tyrol ◽  
Electronic Health ◽  
The Impact

Abstract Background Systematic strategies promoting quality of care in general practice are yet under-represented in several European countries. Objective This interventional study assessed whether a combined intervention (self-audit, benchmarking, quality circles) improved quality of care in Salzburg, Austria and South Tyrol, Italy. The present publication reports the Italian results. Methods We developed quality indicators for general practice in a consensus process based on pre-existing quality programmes. The indicators addressed diagnosis and treatment regarding eight common chronic conditions. A quality score comprising 91 indicators was calculated (0–5 points per indicator depending on fulfilment, maximum 455 points). We collected anonymous data from the electronic health records of the participating physicians in 2012, 2013 and 2014. Wilcoxon signed-rank tests were used for pre-post analysis. Results Thirty-six GPs participated in the study. The median quality score increased significantly from 177.0 points at baseline to 272.0 points at the second follow-up (P = 0.000). Improvements concerned process and intermediate outcome indicators particularly between baseline and the first follow-up. Conclusion Performance was relatively low at baseline and improved considerably, mainly in the first study period. The intervention investigated in this study can serve as a model for future quality programmes. A customized electronic health record for the implementation of this intervention as well as standardized and consistent documentation by GPs is a prerequisite. Use of a limited set of quality indicators (QIs) and regular QI modification is probably advisable to increase the benefits. Long-term prospective studies should investigate the impact of QI-based interventions on end-result outcomes.

Opportunities and Pitfalls of Quality Management

2019 ◽  
pp. 27-34
Author(s):  
Didier Verhoeven ◽  
Sabine Siesling ◽  
Lee Tucker
Keyword(s):  
Quality Of Care ◽  
Quality Management ◽  
Quality Indicators ◽  
Third Party ◽  
Standards Of Care ◽  
Treatment Modalities ◽  
Challenges And Opportunities ◽  
Party Differences ◽  
Clinical Variation

Abstract: Quality of care is the degree to which health services are in accordance with the desired outcome and consistent with current professional knowledge and standards of care. Overuse, underuse, and misuse of diagnostic and treatment modalities may harm patients. Difficulties are present in defining the right standard. Quality indicators try to measure the quality management of the patients. Many challenges and opportunities are present in their development: they must be defined correctly and calculated using accurate data sources. Overall quality of care depends on the optimal quality at any stage of the health care process. Registration and monitoring must be done by an ‘independent’ trusted third party. Differences in quality indicators can lead to benchmarking, learning from best practices, and to better outcome at a lower cost. Following the Plan–Do–Check–Act cycle helps reduce unwanted clinical variation.

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