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Promoting quality: the health-care organization from a management perspective
Ist Teil von
International journal for quality in health care, 2007-12, Vol.19 (6), p.341-348
Ort / Verlag
England: Oxford University Press
Erscheinungsjahr
2007
Quelle
Oxford Journals 2020 Medicine
Beschreibungen/Notizen
AbstractBackground Although agreement about the need for quality improvement in health care is almost universal, the means of achieving effective improvement in overall care is not well understood. Avedis Donabedian developed the structure–process–outcome framework in which to think about quality-improvement efforts. Issue There is now a robust evidence-base in the quality-improvement literature on process and outcomes, but structure has received considerably less attention. The health-care field would benefit from expanding the current interpretation of structure to include broader perspectives on organizational attributes as primary determinants of process change and quality improvement. Solutions We highlight and discuss the following key elements of organizational attributes from a management perspective: (i) executive management, including senior leadership and board responsibilities (ii) culture, (iii) organizational design, (iv) incentive structures and (v) information management and technology. We discuss the relevant contributions from the business and medical literature for each element, and provide this framework as a roadmap for future research in an effort to develop the optimal definition of ‘structure’ for transforming quality-improvement initiatives.