Organizational Quality Improvement Research Articles

Quality improvement development in Swedish healthcare and welfare services

PurposeQuality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and illuminate the development of Quality Improvement (QI) in Swedish healthcare and welfare organizations by using publications in a Swedish context.Design/methodology/approachThe overview synthesis is inspired by a scoping literature review approach of relevant literature. All publications relevant to Swedish healthcare and welfare settings between 1992 until 2020 were included.FindingsIn all, 213 papers, 29 books and chapters and 34 dissertations related to QI and research in Swedish healthcare and welfare context were identified. From 2011 to 2020, the publication rate increased rapidly. Six different focus areas emerged: systematic and value-creating improvement work; collaboration between organizations and healthcare providers; use of improvement methods and (theoretical) models; leadership and learning; measurements, quality registers and follow-up; and involvement and patient safety. Further QI development in Swedish healthcare and welfare points to an increased importance of collaboration between organizations and coproduction with beneficiaries for the healthcare and welfare services.Originality/valueThis paper is one of the first to describe and illuminate the QI development in the healthcare and welfare sector in a country. The trajectory also points to a need for coproduction to handle future challenges.

Review of the Training Room "The Role of Training Management Personnel"

In the context of human resources development (HRD), the role of training management personnel is crucial in ensuring the effectiveness and success of training programs [1]. This article aims to delve deeper into the roles and characteristics of the four main groups of training management personnel: instructors, educators, educational staff, and other personnel. Instructors, as the frontline in the teaching and learning process, play a crucial role in delivering content and facilitating learning. They not only possess adequate technical expertise in their respective fields but also have good communication skills to deliver information in an engaging and meaningful way to training participants. Educators, often integral parts of the teaching team, are responsible for curriculum planning, development, and management. They design effective learning strategies, develop relevant evaluation tools, and are responsible for continuous monitoring and improvement of training programs. Educational staff, on the other hand, are responsible for the administrative and operational management of training programs. They plan and organize training activities, manage facilities and available resources, and ensure that all administrative aspects run smoothly to support the smooth implementation of programs. In addition to these three main groups of training management personnel, there are also other personnel who support the implementation of training programs. This includes administrative staff handling general administration, technicians responsible for facility maintenance, and other facilitators who assist in the implementation of training activities. Through a deeper understanding of the roles and characteristics of each group of training management personnel, it is hoped that training institutions can improve the overall effectiveness, efficiency, and quality of the programs they offer, thereby making significant contributions to HRD and organizational quality improvement [ 4].

Quality 5.0: Towards sustainable quality improvement in organizations


 
 
 The concept of Quality 5.0 in management sciences has emerged relatively recently. It is an attempt to respond to the limitations attributed to Quality 4.0, which focuses on industry and the use of advanced technologies mainly in production processes. Quality 5.0 goes beyond this framework and introduces an equally strong human and social factor. The article defines the concept of Quality 5.0 in relation to quality improvement in organizations and presents the author’s conceptual model of Quality 5.0 as a sustainable concept for quality improvement. The proposed model consists of 12 attributes of Quality 5.0, divided into four categories: (1) Balanced Techno-Human Centric Management System: agile and aware leadership, real-time data decision making, continuous improvement; (2) Human: empowerment, creativity, diversity; (3) Process: integration, efficiency, flexibility; (4) Technology: analytics, connectivity, and scalability. In the Quality 5.0 model, the organization supports the Triple Bottom Line of Sustainable Development through value co-creation, problem-solving, cooperation, and innovation.
 
 

Review: Medical directors - Is there a need for reform?

Medical leadership remains integral to the health system amidst a growing burden of ill health and disease, rising patient expectations and medical and technological advancements. The study objectives were to (a) provide a perspective through a rapid review of medical director roles and responsibilities in public and private hospital settings across several Organisation for Economic Co-operation and Development (OECD) and Non-Organisation for Economic Co-operation and Development countries, and (b) provide recommendations on how health system performance could be strengthened. A rapid review of Medical Director job descriptions in public and private hospitals was carried out. Medical Directors are influential leaders in organisational decision-making and quality improvement; however, their role has shifted from clinical oversight to several managerial and leadership roles. We report some variation in their role and responsibilities, in the 'intensity of job requirements' and 'complexity of managing resources' dimensions. The changing expectations of medical directors and the variation in their roles and responsibiliteis may contribute to inefficiencies and misalignment within health systems. There may be a need to pursue reform to assure alignment with health system objectives, albeit reform may require different approaches to meet the needs of different health systems. Further research is needed to explore how reform of medical directors' roles and responsibilities can be quantified to demonstrate improvement within health systems.

Organizational Culture and Quality Improvement on Sustainability Performance During the First Year of Covid-19 in the Healthcare Industry

This research examines employees’ perceptions of green practices implemented in organizations and their impacts on sustainability performance focusing on the healthcare industry during the first year of COVID-19. It explores how organizational culture and quality improvement practices affect the relationship between green practices and sustainability performance. Results indicate a multi-level framework that organizational culture and quality improvement practices significantly affect the relationship between green practices and healthcare organizations’ sustainability performance.

Perspectives on a virtual student-led research conference in ophthalmology.

We share our experience of organizing a one-day virtual educational event, the first Canadian national student ophthalmology conference, in response to the need for ophthalmology career exploration. The conference included mentorship with residents, research presentations, keynote speakers, and more. Following the event, students expressed some improvement in accessing ophthalmology mentorship and research opportunities, along with a modest enhancement in their understanding of the specialty. We provide insights into the organizational framework and quality improvement results, aiming to assist students in adapting similar events for various specialities.

Reducing Opioid Prescriptions after Common Outpatient Pediatric Urologic Surgeries: A Quality Improvement Assessment.

We formally challenged providers at our institution to reduce opioid doses per prescription and administration to patients overall. We performed a retrospective chart review at our single pediatric institution to establish baseline opioid prescribing values from July 2017 to March 2018. We aimed to reduce this value by 50% in 6 months and sustain this decrease throughout the project duration. We performed 1,518 orchiopexies, 1,505 circumcisions, and 531 IHRs. The percent change in the average number of opioid doses prescribed per patient from baseline values assessed to 2021 was statistically significant for orchiopexies (P < 0.0001), IHRs (P < 0.0001), and circumcisions (P < 0.0001). In addition, the change in the percentage of patients prescribed opioids from baseline was statistically significant for all 3 procedures (P < 0.001). This project demonstrated that through an organized quality improvement initiative, the average number of opioid medications prescribed and the total percentage of patients prescribed opioids following common outpatient pediatric urologic procedures can be decreased by at least 50% and sustained through project duration.

Using Rural Hospital-Wide Voices for Calls to Action

Objective: To utilize Trego County-Lemke Memorial Hospital (TCLMH) employee confidential survey perceptions obtained in April, July, and October yearly to decipher needed hospital environment, job satisfaction, and/or ethical standards for systematic, organizational quality improvement projects. Methodology: Following survey deployment and analysis, organizational change projects will be selected and implemented by transformational leaders. Results: Pending project implementation. Plan is to use a longitudinal, mixed methods, convergent parallel design to analyze employee aggregated Likert-type survey data using SPSS © ANOVA, and open survey comments will adhere to qualitative Thematic Analysis using Dedoose©. Conclusion: This project will implement transformational employee leadership to systematically address or improve employee reported hospital concerns.

The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review

BackgroundReturn on Investment (ROI) is increasingly being used to evaluate financial benefits from healthcare Quality Improvement (QI). ROI is traditionally used to evaluate investment performance in the commercial field. Little is known about ROI in healthcare. The aim of this systematic review was to analyse and develop ROI as a concept and develop a ROI conceptual framework for large-scale healthcare QI programmes.MethodsWe searched Medline, Embase, Global health, PsycInfo, EconLit, NHS EED, Web of Science, Google Scholar using ROI or returns-on-investment concepts (e.g., cost–benefit, cost-effectiveness, value). We combined this terms with healthcare and QI. Included articles discussed at least three organisational QI benefits, including financial or patient benefits. We synthesised the different ways in which ROI or return-on-investment concepts were used and discussed by the QI literature; first the economically focused, then the non-economically focused QI literature. We then integrated these literatures to summarise their combined views.ResultsWe retrieved 10 428 articles. One hundred and two (102) articles were selected for full text screening. Of these 34 were excluded and 68 included. The included articles were QI economic, effectiveness, process, and impact evaluations as well as reports and conceptual literature. Fifteen of 68 articles were directly focused on QI programme economic outcomes. Of these, only four focused on ROI. ROI related concepts in this group included cost-effectiveness, cost–benefit, ROI, cost-saving, cost-reduction, and cost-avoidance. The remaining articles mainly mentioned efficiency, productivity, value, or benefits. Financial outcomes were not the main goal of QI programmes. We found that the ROI concept in healthcare QI aligned with the concepts of value and benefit, both monetary and non-monetary.ConclusionOur analysis of the reviewed literature indicates that ROI in QI is conceptualised as value or benefit as demonstrated through a combination of significant outcomes for one or more stakeholders in healthcare organisations. As such, organisations at different developmental stages can deduce benefits that are relevant and legitimate as per their contextual needs.Trial registrationReview registration: PROSPERO; CRD42021236948.

Assessing the Relationship Between Team Spirit and Organisational Performance of AMAC Staff

The issue of low team spirit in Nigerian government organisations has become a pertinent issue in contemporary times and has continued to linger with derailed organisational performance ensuing. However, several scholars have applied different factors to ascertain the relationship between team spirit and organisational performance in several organisations in Nigeria and found mixed results. This study sought to determine the relationship between team spirit and organisational performance among Abuja Municipal Area Council (AMAC) staff in Nigeria. Using a survey research design, primary data were obtained with questionnaires distributed to AMAC staff. 341 questionnaires were distributed, of which 259 were properly filled out and returned, representing a 75.95% return rate. The analytical methods employed were descriptive statistics and correlation analysis. The results that ensued from this study revealed that there is a high correlation between team spirit (esprit de corps) and the performance of AMAC staff, with a correlation coefficient of 0.994. The study concluded that team spirit is strongly and positively related to team performance. As a result, where there is a high level of team spirit, there is bound to be a high level of organisational quality output and improvement. The study recommended that there is a need for proper communication channels among the team members working in the AMAC organisation. This is so in order to eschew the lack of information about job duties and requirements, which can serve as an impediment to the organization, and it is further stated that a cordial relationship should be established between teams in order to promote effective and efficient attainment of the goals of the AMAC organisation.

Influenza Vaccination in Perioperative Settings: A Teachable Moment.

Influenza Vaccination in Perioperative Settings: A Teachable Moment.

Patients Satisfaction with the Quality of Service in Clinical Pathology Laboratory in Jos University Teaching Hospital (JUTH)

Background: Clients satisfaction have gained increasing attention as meaningful and important sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However, there only very few published studies reporting of the improvement resulting from feedback information of patient surveys, and in most cases, these studies are not in line with their findings. The patients become the main strategy for the main strategy for the organization of health services. This is the era of patients centre care. The study attempts to evaluate patients satisfaction with quality of service offered by clinical pathology Department in JUTH. Materials and methods: 150 Subjects were recruited after consent by random sampling through an inquiry conducted anonymously during the months of January and May 2017. The age range is between eighteen to seventy years. The inquiry was in form of questionnaire with the following questions: accessibility to the laboratory, cleanliness of the laboratory, patients-staff interpersonal relationship, waiting time and turn around time (TAT), labeled 1,2,3,4,5 respectively. Classification of the calculation results of questionnaires was carried out in three categories, namely good service quality, service quality is good enough, and the quality of service quality, service quality is good enough, and the quality of service is not good. Results: This study showed very high overall satisfaction of patients on service in clinical pathology laboratory (80.4%). The levers of cleanliness, communication level and TAT have the highest satisfaction with 99%, 95% and 93% respectively. Those with good enough falls into the category of accessibility and time taken with 52% and 63% respectively. The overall degree of satisfaction is 80.4%. Conclusion: The patients satisfaction in the lever of cleanness, communication, and TAT was the highest (good quality service) and the lowest of the levers ......

Empirical Analysis of Organization Quality-Specific Immune Evolution of Intelligent Manufacturing Enterprises Based on Self-Organization Methods.

Strengthening organization quality-specific immune is the key linkage to improve the quality performance of intelligent manufacturing enterprises. organization quality-specific immune is constructed by selecting four state variables of organization quality cognition, monitor, defense, and memory. Based on the perspective of self-organization, self-organization theory and methods are used to construct the evolution model of organization quality-specific immune. According to four state variables, the evolution of organization quality-specific immune of fourteen typical intelligent manufacturing enterprises is studied, and the conclusion is drawn according to the relaxation coefficient. The empirical results show that self-organization theory and self-organization methods can effectively analyze the evolution of organization quality-specific immune and provide new inspiration for organization quality improvement and quality management of intelligent manufacturing enterprises. The finding results will present the framework for practicing engineering managers of intelligent manufacturing enterprises to enhance organization quality performance and organization quality-specific immune performance and promote organization quality-specific immune evolution.

Green practices and sustainability performance: the exploratory links of organizational culture and quality improvement practices

PurposeThe purpose of this study is to examine the direct and indirect effects of organizational culture and quality improvement practices on the relationship between green practices and sustainability performances by using the structural equation modeling (SEM) approach.Design/methodology/approachStructured questionnaires were used to collect data from 330 full-time managerial employees in established businesses. The relationships depicted in the proposed conceptual model were tested through six hypotheses. IBM SPSS Statistics and SEM-AMOS were used to test the hypotheses.FindingsThe results supported proposed relationships in the model, except the one between organizational culture and green practices. The findings indicate that the more employees are aware of companies’ green practices, the more likely they are going to feel positive about the sustainability performance of the organization. Additionally, a strong organizational culture that supports the green movement and quality improvement practices lead to positive sustainability outcomes.Research limitations/implicationsA larger sample size in several major industries would allow the development of industry-specific sustainability strategies and best practices. In addition, a study based in a different geographical location in the USA or in a different country is recommended to see if the findings can be generalized across different industries, geographical locations or countries.Practical implicationsSustainability has undoubtedly become a major concern for many companies today. The findings of this study provide important guidelines for practitioners to balance the implementation of green practices, organizational culture, quality improvement practices and sustainability performance dimensions. Profitability and sustainability can be achieved together when companies are willing to continuously pay attention to environmental issues and strategically invest in initiatives that are cost-efficient and eco-friendly.Originality/valueThis study is one of the first that explores how organizational culture and quality improvement practices affect directly and indirectly the relationship between green practices and sustainability performance. The results imply that organizational culture and quality improvement practices significantly affect the relationship between green practices and the sustainability performance dimensions.

Use of an Appreciative Inquiry Approach to Enhance Quality Improvement in Management of Patient Care

Background: Different approaches are available to facilitate employees’ motivation, involving them in decision making and participating in different activities. Due to changes and the widespread dissatisfaction with the management of the current South African health system, various approaches to enhance quality improvement in management have emerged. However, their effects on the quality of care have been unsatisfactory. This article describes how an appreciative inquiry was used to facilitate motivation and promote organisational quality improvement in the management of patient care.

Health care services satisfaction and associated factors among people living with HIV/AIDS at Kibuye referral hospital, Rwanda

Background: Patient satisfaction surveys have gained great attention as meaningful parameters for evaluating quality improvement in healthcare organizations. At Kibuye referral hospital, healthcare utilization and health care services for people living with HIV/AIDS (PLWHA) has been low, as attested by poor adherence to medication and weakening of patients due the disease progression. The main objective of this study was to assess healthcare services satisfaction and associated factors among people living with HIV/AIDS Kibuye referral hospital, Rwanda. Methods: An institutional-based cross-sectional design was used to select 277 study participants who were interviewed by use of a structured questionnaire, and the data analyzed quantitatively. Two focus group discussions (FGDs) were performed, after which the interviews were transcribed in verbatim and analyzed thematically.Results: The overall level of PLWHA satisfaction was 95.0%. In multivariate analysis, social class and age were found to be the main predictors of PLWHA satisfaction (AOR=10.218, 95% CI=1.39, 74.88, p=0.002) and (AOR=0.39, CI=0.121 to 1.186, p=0.005), respectively. Qualitative study outcome showed that health care service delivery at Kibuye referral hospital is measured by a number of factors, including timeliness of health care service delivery, meeting needs of clients and paying attention in provision of health care services.Conclusions: The level of patient satisfaction was found to be high. When individual was of high-class status in the society, and were above 20 years of age, his or her satisfaction increased. The study recommends that PLWAs are treated equally so as to improve service delivery, particularly among people living HIV/AIDS.

Quality Innovation in Healthcare – The Challenge of the Third Era

Abstract In the third era of quality assurance in health care, innovation is no longer the exclusive focus area of the individual medical professional dedicated to optimizing patient care nor is it achieved by design thinking by the health delivery organization aiming for economic sustainability. Change platform in the third era is the community of professionals, committed to providing the best possible care within the limits of organizational logic. We aim to clarify the conditions for sustainable quality improvement in health delivery organizations and in doing so to provide a means of improving initial feasibility assessment by identifying critical factors in the cooperation between different parties. We designed a model representing the sources of influence on the process of decision making regarding the selection of innovations and choosing the most effective implementation strategy. These sources are: aspects of legitimacy, core values and change readiness. We tested this model on a project, aimed at improving the efficiency of the OR in a Dutch University Clinic. The example project failed to deliver the projected outcome because of non-disclosed conflicting interpretations of core values and an implicit controversial status shift between medical professionals and OR management. This confirms the explaining power of our model. Successful implementation of quality innovation in health care depends (among other things) on addressing the challenges of differing concepts of legitimacy, conflicting core values and varying change readiness between social systems in complex organizations. Installing a QIC as such does not meet these challenges.

Using the Theoretical Domains Framework to Identify Barriers and Facilitators to Elder-Friendly Care Implementation Within a Multi-Site Academic Health Centre.

Societal demographic shifts are occurring globally. Within Quebec, Canada, the percentage of adults over 65 (older adults) is predicted to increase from 19.3% to >25.9% by the year 2036. Older adults (OAs) experience hospitalizations more frequently than persons aged 15-64years old, and hospitalizations for OAs can be detrimental due to naturally occurring physiological changes. To address the needs of this population, the Quebec government mandated that all acute care hospitals implement OA-friendly care standards called AAPA ("l'Approche Adaptée à la Personne Âgée"). To describe an approach for identifying barriers and facilitators (BFs) to AAPA implementation at the McGill University Health Centre, an academic healthcare centre in Montreal that provides tertiary and quaternary care. Our approach included an organizational quality improvement (QI) model based on the Institute for Healthcare Improvement QI approach and the use of the Theoretical Domains Framework (TDF) to guide the assessment of BFs to AAPA implementation. To identify the BFs of AAPA implementation, themes were generated from the raw data. In total, 32 barriers and 88 facilitators were identified. Each BF was linked to one or more corresponding domain from the TDF. Seven of the most frequently occurring domains were: (1) knowledge, (2) beliefs about consequences, (3) social/professional role and identity, (4) social influences, (5) environmental context and resources, (6) intentions, and (7) goals. A theory-informed approach, such as the TDF, can be used to facilitate the implementation of evidence-based guidelines.

Strategic Leadership as a Mediating Variable between Organisational Climate and Quality Improvement in Higher Education

The quality of higher education systems depends mainly on leaders. This study describes how strategic leadership influences organizational climate and enhances the continuous quality improvement of the university. Besides, this study sought to examine the mediating impact of strategic leadership on the relationship between organizational climate and continuous quality improvement in a specific context of Tanta universities in Egypt. A quantitative research design was used in this study. Data were collected from 165 lecturers from the faculty of medicine. For achieving the study's objective, SPSS version 26 and Smart PLS 3.3 software were used to analyze the data. The study revealed that strategic leadership has a full mediating influence on the relationship between organizational climate and continuous quality management. The study suggests that more emphasis should be laid on organizational climate in terms of university sources. Finally, the study concluded that the organizational climate could be improved through strategic leadership. The study recommended that the top management creates a suitable climate that improves quality improvement in Egypt's public university.

Concession as a state investment policy tool

Russian Federation’s competitiveness is largely interconnected with the state investment policy’s development level. However, the need for investments in high-quality infrastructure, on the one hand, and corresponding budget funds deficit, on the other hand, highlight the problem of the state and business entities’ cooperation by means of concession. At the same time there are many barriers, which hinder the concession’s consecutive development. That is why the research goal includes the elaboration of measures, aimed at the effective application of a concession as a tool of state investment policy. The systematic approach and a set of scientific measures, including observation, expert assessment, statistical data processing, analysis and comparison have been applied in the study. As a result, the research authors define the following growth areas of a concession: legal normative (normative consolidation of the concession’s development strategies and programmes, quality improvement of the methodological and legal concession projects elaboration), production organizational (quality improvement of territorial planning when proposing concessional agreements, the application of a complex approach to concession’s facilities’ modernization and etc.) and economic (broadening the spectrum of budgetary and non-budgetary tools used for financing concessional projects, elaboration of reasonable requirements to guarantee exposure according to the concessional agreement and etc.).