Show simple item record

dc.contributor.authorVaughn, VM
dc.contributor.authorSaint, S
dc.contributor.authorKrein, SL
dc.contributor.authorForman, JH
dc.contributor.authorMeddings, J
dc.contributor.authorAmeling, J
dc.contributor.authorWinter, S
dc.contributor.authorTownsend, W
dc.contributor.authorChopra, V
dc.date.accessioned2020-02-20T22:23:03Z
dc.date.available2020-02-20T22:23:03Z
dc.date.issued2019
dc.identifier.issn2044-5415
dc.identifier.doi10.1136/bmjqs-2017-007573
dc.identifier.urihttp://hdl.handle.net/10072/391751
dc.description.abstractBackground: Identifying characteristics associated with struggling healthcare organisations may help inform improvement. Thus, we systematically reviewed the literature to: (1) Identify organisational factors associated with struggling healthcare organisations and (2) Summarise these factors into actionable domains. Methods: Systematic review of qualitative studies that evaluated organisational characteristics of healthcare organisations that were struggling as defined by below-average patient outcomes (eg, mortality) or quality of care metrics (eg, Patient Safety Indicators). Searches were conducted in MEDLINE (via Ovid), EMBASE, Cochrane Library, CINAHL, and Web of Science from database inception through February 8 2018. Qualitative data were analysed using framework-based synthesis and summarised into key domains. Study quality was evaluated using the Critical Appraisal Skills Program tool. Results: Thirty studies (33 articles) from multiple countries and settings (eg, acute care, outpatient) with a diverse range of interviewees (eg, nurses, leadership, staff) were included in the final analysis. Five domains characterised struggling healthcare organisations: poor organisational culture (limited ownership, not collaborative, hierarchical, with disconnected leadership), inadequate infrastructure (limited quality improvement, staffing, information technology or resources), lack of a cohesive mission (mission conflicts with other missions, is externally motivated, poorly defined or promotes mediocrity), system shocks (ie, events such as leadership turnover, new electronic health record system or organisational scandals that detract from daily operations), and dysfunctional external relations with other hospitals, stakeholders, or governing bodies. Conclusions: Struggling healthcare organisations share characteristics that may affect their ability to provide optimal care. Understanding and identifying these characteristics may provide a first step to helping low performers address organisational challenges to improvement.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Publishing
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefrom74
dc.relation.ispartofpageto84
dc.relation.ispartofissue1
dc.relation.ispartofjournalBMJ Quality and Safety
dc.relation.ispartofvolume28
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchCurriculum and Pedagogy
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1103
dc.subject.fieldofresearchcode1302
dc.subject.keywordshealthcare quality improvement
dc.subject.keywordsleadership
dc.subject.keywordspatient safety
dc.subject.keywordsqualitative research
dc.subject.keywordsquality improvement
dc.titleCharacteristics of healthcare organisations struggling to improve quality: Results from a systematic review of qualitative studies
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationVaughn, VM; Saint, S; Krein, SL; Forman, JH; Meddings, J; Ameling, J; Winter, S; Townsend, W; Chopra, V, Characteristics of healthcare organisations struggling to improve quality: Results from a systematic review of qualitative studies, BMJ Quality and Safety, 2019, 28 (1), pp. 74-84
dcterms.dateAccepted2018-06-24
dcterms.licensehttp://creativecommons.org/licenses/by-nc/4.0/
dc.date.updated2020-02-20T21:29:53Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2019 The Author(s). This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
gro.hasfulltextFull Text
gro.griffith.authorChopra, Vineet


Files in this item

This item appears in the following Collection(s)

  • Journal articles
    Contains articles published by Griffith authors in scholarly journals.

Show simple item record