The impact of redesigning care processes on quality of care: a systematic review

Background: This literature review evaluates the current state of knowledge about the impact of process redesign on the quality of healthcare. Methods: Pubmed, CINAHL, Web of Science and Business Premier Source were searched for relevant studies published in the last ten years [20042014]. To be included, studies had to be original research, published in English with a before-and-after study design, and be focused on changes in healthcare processes and quality of care. Studies that met the inclusion criteria were independently assessed for excellence in reporting by three reviewers using the SQUIRE checklist. Data was extracted using a framework developed for this review. Results: Reporting adequacy varied across the studies. Process redesign interventions were diverse, and none of the studies described their effects on all dimensions of quality defined by the Institute of Medicine. Conclusions: The results of this systematic literature review suggests that process redesign interventions have positive effects on certain aspects of quality. However, the full impact cannot be determined on the basis of the literature. A wide range of outcome measures were used, and research methods were limited. This review demonstrates the need for further investigation of the impact of redesign interventions on the quality of healthcare. Keywords: Process redesign, Quality of care, Healthcare processes, Systematic revie

So Happy Together: A Review of the Literature on the Determinants of Effectiveness of Purpose-Oriented Networks in Health Care

While purpose-oriented networks are widely recognized as organizational forms to address wicked problems in health care such as increasing demands and expenditure, the associated literature is fragmented. We therefore reviewed empirical studies to identify the determinants of the effectiveness of these networks. Our search yielded 3,657 unique articles, of which 19 met our eligibility criteria. After backward snowballing and expert consultation, 33 articles were included. Results reveal no less than 283 determinants of effective health care networks. The majority of these determinants are processual and involving professionals from the operational level is particularly salient. In addition, most studies relate determinants to process outcomes (e.g., improved collaboration or sustainability of the network) and only a few to members' perception of whether the network attains its goals. We urge future research to adopt configurational approaches to identify which sets of determinants are associated with networks' ability to attain their goal of addressing wicked problems

Agree to disagree: The relationship of heterogeneity in team culture with integrated patient care

Organizational culture is considered critical for improving health system outcomes. Yet, empirical evidence confirming this relationship is limited. This may be due to the prevailing way that studies conceptualize culture using a consensus perspective, which assumes that more agreement among members is better. However, to meet multiple healthcare needs of patients with complex conditions, diverse providers with various disciplinary backgrounds increasingly must work together. Given the need for multidisciplinary collaboration, using what Chan (1998) calls a dispersion model may be more suitable to explain variations in team performance. A dispersion model conceptualizes organizational culture through heterogeneity among groups instead of within group agreement. To recognize the heterogeneity in values and skills that different healthcare professionals introduce to multidisciplinary teams, we assess whether heterogeneity in team cultures is associated with the degree to which patients perceive care to be m..

Cross-Cultural Validation of the Patient Perception of Integrated Care Survey

Objective To test the cross‐cultural validity of the U.S. Patient Perception of Integrated Care (PPIC) Survey in a Dutch sample using a standardized procedure. Data Sources Primary data collected from patients of five primary care centers in the south of the Netherlands, through survey research from 2014 to 2015. Study Design Cross‐sectional data collected from patients who saw multiple health care providers during 6 months preceding data collection. Data collection The PPIC survey includes 59 questions that measure patient perceived care integration across providers, settings, and time. Data analysis followed a standardized procedure guiding data preparation, psychometric analysis, and included invariance testing with the U.S. dataset. Principal Findings Latent scale structures of the Dutch and U.S. survey were highly comparable. Factor “Integration with specialist” had lower reliability scores and noninvariance. For the remaining factors, internal consistency and invariance estimates were strong. Conclusions The standardized cross‐cultural validation procedure produced strong support for comparable psychometric characteristics of the Dutch and U.S. surveys. Future research should examine the usability of the proposed procedure for contexts with greater cultural differences