Evaluation and measurement for improvement in service-level quality improvement initiatives

The National Health Service (NHS) in England, as with other health services worldwide, currently faces the need to reduce costs and to improve the quality of patient care. Evidence gathered through effective and appropriate measurement and evaluation, is essential to achieving this. Through interviews with service improvement managers and analysis of comments in a seminar of NHS staff involved in health service improvement, we found a lack of understanding regarding the definition and methodology of both measurement and evaluation, which decreases the likelihood that NHS staff will be competent to commission or provide these skills. In addition, we highlight the importance of managers assessing their organizations' 'readiness' to undergo change before embarking on a quality improvement (QI) initiative, to ensure that the initiative's impact can be adequately judged. We provide definitions of measurement for improvement and of evaluation, and propose a comparative framework from which to gauge an appropriate approach. Examples of two large-scale QI initiatives are also given, along with descriptions of some of their problems and solutions, to illustrate the use of the framework. We recommend that health service managers use the framework to determine the most appropriate approach to evaluation and measurement for improvement for their context, to ensure that their decisions are evidence based

Command and control : international negotiations and alliances

32 page(s

Responsibility caps from strategy to operations in leadership and management : conceptual model

Major scale strategy transitions seems to fail in most cases. Former researches shows that there has been large amounts of efforts to develop and study strategy formulation, but strategy implementation has been left with minor interest. This article focuses to strategy implementation from obstacles perspective. Article binds obstacles, actions and phases in strategy implementation to one holistic concept and provides ground for future research. Approach is integrating leadership, management and time management matters to change management in strategy implementation. Article highlights the responsibilities of top and middle management