Web of Science: 76 cites, Scopus: 75 cites, Google Scholar: cites,
The influence of context on the effectiveness of hospital quality improvement strategies : a review of systematic reviews
Kringos, Dionne S. (University of Amsterdam. Department of Public Health)
Sunol, Rosa (Universitat Autònoma de Barcelona. Institut Universitari Avedis Donabedian)
Wagner, Cordula (NIVEL, Netherlands Institute for Health Services Research)
Mannion, Russell (Health Services Management Centre, University of Birmingham)
Michel, Philippe (Quality and Safety Department, Lyon University, Hospital Network)
Klazinga, Niek S. (University of Amsterdam. Department of Public Health)
Groene, Oliver (London School of Hygiene & Tropical Medicine. Department of Health Services Research and Policy)
DUQuE Consortium

Data: 2015
Resum: It is now widely accepted that the mixed effect and success rates of strategies to improve quality and safety in health care are in part due to the different contexts in which the interventions are planned and implemented. The objectives of this study were to (i) describe the reporting of contextual factors in the literature on the effectiveness of quality improvement strategies, (ii) assess the relationship between effectiveness and contextual factors, and (iii) analyse the importance of contextual factors. We conducted an umbrella review of systematic reviews searching the following databases: PubMed, Cochrane Database of Systematic Reviews, Embase and CINAHL. The search focused on quality improvement strategies included in the Cochrane Effective Practice and Organisation of Care Group taxonomy. We extracted data on quality improvement effectiveness and context factors. The latter were categorized according to the Model for Understanding Success in Quality tool. We included 56 systematic reviews in this study of which only 35 described contextual factors related with the effectiveness of quality improvement interventions. The most frequently reported contextual factors were: quality improvement team (n = 12), quality improvement support and capacity (n = 11), organization (n = 9), micro-system (n = 8), and external environment (n = 4). Overall, context factors were poorly reported. Where they were reported, they seem to explain differences in quality improvement effectiveness; however, publication bias may contribute to the observed differences. Contextual factors may influence the effectiveness of quality improvement interventions, in particular at the level of the clinical micro-system. Future research on the implementation and effectiveness of quality improvement interventions should emphasize formative evaluation to elicit information on context factors and report on them in a more systematic way in order to better appreciate their relative importance.
Ajuts: European Commission 241822
Drets: 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. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Publicat a: BMC health services research, Vol. 15 (july 2015) , ISSN 1472-6963

DOI: 10.1186/s12913-015-0906-0
PMID: 26199147

13 p, 729.3 KB

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