Deepening our understanding of quality improvement in Europe (DUQuE) : overview of a study of hospital quality management in seven countries
Secanell, Mariona (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Groene, Oliver (London School of Hygiene and Tropical Medicine)
Arah, Onyebuchi A.. (University of California. Department of Epidemiology)
Lopez, Maria Andrée (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Kutryba, Basia (Polish Society for Quality Promotion in Health Care)
Pfaff, Holger (Universität zu Köln)
Klazinga, Niek (Amsterdam Universitair Medische Centra (Amsterdam, Països Baixos))
Wagner, Cordula (NIVEL (Utrecht, Països Baixos))
Kristensen, Solvejg (Aalborg Universitet)
Bartels, Paul (Aalborg Universitet)
Garel, Pascal (European Hospital and Healthcare Federation (Brussel·les, Bèlgica))
Bruneau, Charles (France. Haute autorité de santé)
Escoval, Ana (Associação Portuguesa para o Desenvolvimento Hospitalar)
França, Margarida (Sociedade Portuguesa para a Qualidade na Saúde)
Mora, Núria (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Suñol Sala, Rosa (Universitat Autònoma de Barcelona)
DUQuE Project Consortium

Fecha:	2014
Resumen:	This paper provides an overview of the DUQuE (Deepening our Understanding of Quality Improvement in Europe) project, the first study across multiple countries of the European Union (EU) to assess relationships between quality management and patient outcomes at EU level. The paper describes the conceptual framework and methods applied, highlighting the novel features of this study. DUQuE was designed as a multi-level cross-sectional study with data collection at hospital, pathway, professional and patient level in eight countries. We aimed to collect data for the assessment of hospital-wide constructs from up to 30 randomly selected hospitals in each country, and additional data at pathway and patient level in 12 of these 30. A comprehensive conceptual framework was developed to account for the multiple levels that influence hospital performance and patient outcomes. We assessed hospital-specific constructs (organizational culture and professional involvement), clinical pathway constructs (the organization of care processes for acute myocardial infarction, stroke, hip fracture and deliveries), patient-specific processes and outcomes (clinical effectiveness, patient safety and patient experience) and external constructs that could modify hospital quality (external assessment and perceived external pressure). Data was gathered from 188 hospitals in 7 participating countries. The overall participation and response rate were between 75% and 100% for the assessed measures. This is the first study assessing relation between quality management and patient outcomes at EU level. The study involved a large number of respondents and achieved high response rates. This work will serve to develop guidance in how to assess quality management and makes recommendations on the best ways to improve quality in healthcare for hospital stakeholders, payers, researchers, and policy makers throughout the EU.
Ayudas:	European Commission 241822
Nota:	En el text de l'article podeu consultar quins són els participants en el DUQuE Project Consortium
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Quality management systems ; Clinical indicators ; Clinical effectiveness ; Quality of healthcare ; Hospitals ; Cross-national research ; Patient outcomes
Publicado en:	International journal for quality in health care, Vol. 26, issue S1 (March 2014) , p. 5-15, ISSN 1464-3677

DOI: 10.1093/intqhc/mzu025
PMID: 24671120

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