2 research outputs found
Prospects for comparing European hospitals in terms of quality and safety
Purpose. Being able to compare hospitals in terms of quality and safety between countries is important for a number of
reasons. For example, the 2011 European Union directive on patients’ rights to cross-border health care places a requirement
on all member states to provide patients with comparable information on health-care quality, so that they can make an
informed choice. Here, we report on the feasibility of using common process and outcome indicators to compare hospitals
for quality and safety in five countries (England, Portugal, The Netherlands, Sweden and Norway).
Main Challenges Identified. The cross-country comparison identified the following seven challenges with respect to comparing
the quality of hospitals across Europe: different indicators are collected in each country; different definitions of the same
indicators are used; different mandatory versus voluntary data collection requirements are in place; different types of organizations
oversee data collection; different levels of aggregation of data exist (country, region and hospital); different levels of
public access to data exist; and finally, hospital accreditation and licensing systems differ in each country.
Conclusion. Our findings indicate that if patients and policymakers are to compare the quality and safety of hospitals across
Europe, then further work is urgently needed to agree the way forward. Until then, patients will not be able to make
informed choices about where they receive their health care in different countries, and some governments will remain in the
dark about the quality and safety of care available to their citizens as compared to that available in neighbouring countries
Enacting quality improvement in ten European hospitals
_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