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Quality improvement in large healthcare organizations Searching for system-wide and coherent monitoring and follow-up strategies
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2016 (English)In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 30, no 1, 133-153 p.Article in journal (Refereed) PublishedText
Abstract [en]

Purpose - The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M&F) processes related to health care quality improvement (QI) and development. Design/methodology/approach - A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings - The demand for improved M&F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M&F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications - A model of important aspects of M&F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization's measurement systems. A systematic M&F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value - Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor's view on important factors to consider when building a coherent organizational M&F strategy.

Place, publisher, year, edition, pages
2016. Vol. 30, no 1, 133-153 p.
Keyword [en]
Change management, Quality improvement, Organizational development, Monitoring and follow-up
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-120369DOI: 10.1108/JHOM-10-2013-0209ISI: 000374156600008PubMedID: 26964854OAI: oai:DiVA.org:umu-120369DiVA: diva2:928747
Available from: 2016-05-16 Created: 2016-05-16 Last updated: 2016-08-15Bibliographically approved

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Höög, ElisabetLysholm, JackWeinehall, Lars
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Epidemiology and Global HealthDepartment of Surgical and Perioperative SciencesDepartment of Public Health and Clinical Medicine
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Public Health, Global Health, Social Medicine and Epidemiology

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