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Article
Publication date: 21 October 2013

Cliff Welborn and Kimball Bullington

– The purpose of this study is to benchmark the use of process improvement techniques among US health care organizations that won the Malcolm Baldrige National Quality Award.

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Abstract

Purpose

The purpose of this study is to benchmark the use of process improvement techniques among US health care organizations that won the Malcolm Baldrige National Quality Award.

Design/methodology/approach

The applications from 13 Baldrige award winning health care organizations were researched to determine which process improvement techniques were used most frequently to guide their operations.

Findings

The results from this study identify several best practices in process improvement techniques. Furthermore, the study pinpoints in which aspect of performance that a process improvement technique is most likely to be used.

Research limitations/implications

Only applications from organizations winning the Baldrige award have been studied. The identity and application for organizations that do not win the award are not released to the public. Statistical analysis of the data is limited to the relatively small number (13) of award winners.

Practical implications

The results clearly show that there are certain process improvement techniques used by a majority of the Baldrige winners. It is not possible to guarantee that the use of these same techniques by other health care organizations will result in performance improvement, only that the winners used the techniques and have achieved a high level of performance. The results identify processes for further benchmarking studies.

Originality/value

The process improvement techniques identified in this study have been used by successful health care organizations. This information may be useful to other health care organizations when deciding on which process improvement techniques to pursue in order to improve their own performance. While the Baldrige award process has driven benchmarking efforts, this study uses the Baldrige process to identify benchmarking opportunities for process improvement in health care organizations.

Details

Benchmarking: An International Journal, vol. 20 no. 6
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 14 August 2007

Wally R. Smith

This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.

861

Abstract

Purpose

This paper aims to compare and contrast quality improvement in the domain of health care disparities with quality improvement in other domains.

Design/methodology/approach

The author provides a descriptive essay and review to put forward the findings of their research.

Findings

In the USA, health care quality improvement systems have largely been accepted and institutionalized. Most if not all hospital and health care systems now have quality monitoring and improvement teams. In contrast, despite a plethora of stark reports in the literature showing that the US health care system has failed to deliver health care with equity when the care of Whites is compared with that of racial and ethnic minorities, there is not a parallel health care disparities improvement system in most health care settings.

Practical implications

Paralleling many steps that have been taken to improve quality in general, health care workers and health systems must take steps to improve structures and processes of care to reduce health care disparities.

Originality/value

Pinpoints some important distinctions between improving structures and processes of care related to health care disparities, and those related to other aspects of quality improvement. Doing so will save lives, and in the process improve overall quality.

Details

Clinical Governance: An International Journal, vol. 12 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 5 July 2011

Mattias Elg, Lars Witell, Bozena Poksinska, Jon Engström, Su Mi Dahlgaard‐Park and Peter Kammerlind

The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care

Abstract

Purpose

The purpose of this paper is to develop an understanding of how patients experience their health problems and how they can generate innovative ideas about health care services. The research questions that guide the present study are: how can solicited diaries be used for capturing patient ideas? What type of data is generated from solicited diaries used for generating patient ideas? And what are the potential benefits and shortcomings of using patient diaries in generating ideas for improvement of health care services?

Design/methodology/approach

The paper is based on an exploratory case study using patient diaries to solicit ideas about how health care services in Sweden can be improved. From the methodological viewpoint, the diaries are used as a tool for patient co‐creation of health care services.

Findings

When analyzing dairies written by patients four different types of diaries emerged from the study: brief, reporting, descriptive and reflective diaries. Furthermore, 102 ideas for improvements within nine areas were identified from the contents of dairies.

Research limitations/implications

Adopting patients' diaries as a way to activate and promote co‐creation of values is at an embryo stage, and hence more research is needed.

Originality/value

One of the strengths of the paper includes its potential for practical implications, either clinical or methodological, by using patients' dairies. It focuses both on the content generated from the diaries for improving health services, as well as the use of the diaries for practicing the idea of patients as co‐creators in health care service.

Details

International Journal of Quality and Service Sciences, vol. 3 no. 2
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 1 October 1998

Johannes Möller and Hans‐Günther Sonntag

The EFQM model for organisational excellence is used in the health care sector as a tool to diagnose and assess the starting position for an effective QM programme…

8369

Abstract

The EFQM model for organisational excellence is used in the health care sector as a tool to diagnose and assess the starting position for an effective QM programme. Feedback reports cover the fields of acute medical care, rehabilitation and ambulant care and contain strengths areas for improvement. Building on the EFQM feedback reports, the Modular Concept for Quality in Health Care (“Heidelberg Model”) improves QM both holistically and specifically by implementing so‐called “Modules for Excellence”. The implementation process follows principles of project management covering medical, nursing and managing issues and the performance is periodically evaluated against targets. QM projects that are designed in the dichotomic way follow three goals. Organisational diagnosis and therapy lead to numerical health care improvements in “Prevention of nosocomial infections” and “Optimising out‐patient treatment”. Different assessment approaches lead to a diagnosing feedback report for QM in health care. The Modular Concept for Quality in Health Care (“Heidelberg Model”) clusters, prioritises, implements and evaluates the organisation’s key areas for improvement.

Details

Health Manpower Management, vol. 24 no. 5
Type: Research Article
ISSN: 0955-2065

Keywords

Article
Publication date: 3 July 2017

James Simon and Mishaela Houle

The purpose of this paper is to discuss improvement of the business of health care delivery through the application of systematic problem solving. This was strengthened by…

Abstract

Purpose

The purpose of this paper is to discuss improvement of the business of health care delivery through the application of systematic problem solving. This was strengthened by recurrence prevention through standardization at every level transforming into culture.

Design/methodology/approach

The methodology utilized is set derived from the true fiber and fabric of Toyota, the Toyota Business Practice (TBP) or eight-step problem solving and its translation into health care thinking by aligning to the process of clinical diagnosis of patients. The methodology that gives energy and direction to TBP is Hoshin Kanri, a Japanese approach to strategic planning. When you combine focus and purpose through strategic direction alongside a culture of systematic problem solving you get results.

Findings

The application of the Toyota mindset resulted in a cultural shift which built on the strength of the current organizational culture. This approach had a broad impact on the program impacting leadership and management roles, improved employee engagement, complete visibility of organizational priorities, improved system performance, visibility and awareness of the vision and defined measures that drive the health care system. This has also resulted in cost diversions of approximately five million dollars CDN.

Originality/value

A grass roots application of real-time problem solving through strategic alignment.

Details

Business Process Management Journal, vol. 23 no. 4
Type: Research Article
ISSN: 1463-7154

Keywords

Article
Publication date: 27 November 2020

Nasr Al-Hinai and Ahm Shamsuzzoha

This study aims to develop a practical methodology to identify possible areas of improvements as well as exploring how to improve the health-care staff flow within a…

Abstract

Purpose

This study aims to develop a practical methodology to identify possible areas of improvements as well as exploring how to improve the health-care staff flow within a selected department in a hospital.

Design/methodology/approach

It focuses on showing how to properly study and analyze the health-care services and processes practiced at a selected department within a hospital. For this, several techniques like non-value-adding activities, time motion study, spaghetti diagram, layout analysis, etc. are used.

Findings

To test the proposed methodology, a neonatal intensive care unit (NICU) of a hospital in Oman was considered as a case study. The study revealed that this unit has several potential improvements capabilities. Further, this study also discussed possible areas of improvements of this case unit and suggested how such improvements can be implemented.

Originality/value

Several possible improvements are suggested and are discussed with the hospital authority, which can be clarified as the re-layout of the NICU rooms, reorganization of the store to improve the staff flow, increase the work efficiency, introduction of Help Us Support Healing policy, etc., which can enhance the entire operational system at the studied NICU.

Details

International Journal of Quality & Reliability Management, vol. 38 no. 6
Type: Research Article
ISSN: 0265-671X

Keywords

Article
Publication date: 31 December 2020

Jonas Boström, Helene Hillborg and Johan Lilja

The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking…

Abstract

Purpose

The purpose of this paper is to contribute knowledge concerning the dynamics and potential cultural tensions that occur when applying user involvement and design thinking (DT) for improving quality in a health-care setting.

Design/methodology/approach

This paper is based on a case study following a quality improvement (QI) project in a medium-sized Swedish county council in the field of somatic care. The project involved eight health-care professionals, one designer, four patients and two relatives. A multiple data collection method over a period of ten months was used. It included individual interviews, e-mail correspondence and observations of workshops that covered the QI project.

Findings

The result shows tensions between QI work and the daily clinical work of the participants. These tensions primarily concern the conflict between fast and slow processes, the problem of moving between different fields of knowledge, being a resource for the individual clinic and the system and the participants’ expectations and assumptions about roles and responsibilities in a QI project. Furthermore, these findings could be interpreted as signs of a development culture in the health-care context.

Practical implications

There are several practical implications. Among others, the insights can inspire how to approach and contextualize the current concepts, roles and methods of DT and user involvement so that they can be more easily understood and integrated into the existing culture and way of working in the health-care sector.

Originality/value

This study provides a unique insight into a case, trying to uncover what actually is going on and perhaps, why certain things are not happening at all, when user involvement and design practices are applied for improving health-care quality.

Details

International Journal of Quality and Service Sciences, vol. 13 no. 1
Type: Research Article
ISSN: 1756-669X

Keywords

Article
Publication date: 28 September 2020

Manisha Kumar, Nicholas Rich, Maneesh Kumar and Ying Liu

This paper aims to explore patient to care provider reverse exchanges to improve the care processes and service supply chain using an online feedback platform. This paper…

Abstract

Purpose

This paper aims to explore patient to care provider reverse exchanges to improve the care processes and service supply chain using an online feedback platform. This paper demonstrates how a better understanding of timely and unsolicited feedback (“voice of the patient as a customer”) stimulates local interventions to improve service delivery and enact the essential characteristics of highly reliable organisations (HRO).

Design/methodology/approach

A realist approach involving an exploratory hospital case study using user feedback from an IT patient feedback platform. The methodology included interviews, secondary data and access to thousands of patient feedback narratives.

Findings

The findings show that a systems approach to the supply chain, using real-time feedback to enact process improvement is beneficial and a fruitful source of innovation for professional services staff. The setting of the improvement focusses on a true “voice of the customer” rather than attempting to improve arbitrarily internal process efficiency has major benefits for staff and their engagement with the right interventions to support higher performance.

Practical implications

The findings show major positive benefits for the adaptation and constant reflection of staff on the service provided to patients. The approach provides a means of reflecting as to whether the current supply chain and service provision are fit for purpose, as well as reliable, efficient and of value to the consumer.

Originality/value

This study is one of a few that adopt the consumer orientation needed to fully exploit the concepts of patient-centric improvement by including dynamic feedback in the supply chain and systems approach to care.

Details

Supply Chain Management: An International Journal, vol. 26 no. 3
Type: Research Article
ISSN: 1359-8546

Keywords

Article
Publication date: 2 August 2013

Fredrik Bååthe and Lars Erik Norbäck

To improve health‐care delivery from within, managers need to engage physicians in organisational development work. Physicians and managers have different…

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Abstract

Purpose

To improve health‐care delivery from within, managers need to engage physicians in organisational development work. Physicians and managers have different mindsets/professional identities which hinder effective communication. The aim of this paper is to explore how managers can transform this situation.

Design/methodology/approach

The authors' interview study reveals physicians' own perspective on engagement for organisational improvement. They discuss identities from three theoretical perspectives and explore the mindsets of physicians and managers. They also explore the need to modify professional identities and how this can be achieved.

Findings

If managers want physicians to engage in improvements, they must learn to understand and appreciate physician identity. This might challenge managers' identity. The paper shows how managers – primarily in a Swedish context – could act to facilitate physician engagement. This in turn might challenge physician identity.

Research limitations/implications

Studies from the western world show a coherent picture of professional identities, despite structural differences in national health‐care systems. The paper argues, therefore, that the results can be relevant to many other health‐care systems and settings.

Originality/value

The paper provides an alternative to the prevailing managerial control perspective. The alternative is simple, yet complex and challenging, and as the authors understand it, necessary for health care to evolve, from within.

Details

Journal of Health Organization and Management, vol. 27 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 26 June 2019

Shashank Mittal

Organizations learn semi-automatically through experience or consciously through deliberate learning efforts. As there seems to be a “black-box” in the possible linkages…

Abstract

Purpose

Organizations learn semi-automatically through experience or consciously through deliberate learning efforts. As there seems to be a “black-box” in the possible linkages between deliberate learning and new practice implementation, this paper aims to develop and test a process model, linking deliberate learning and new practice implementation through complementary competencies of task and environmental flexibility.

Design/methodology/approach

As part of a field study, health-care improvement program (to transfer the improvement training program for new practice implementation) of 186 HCUs was used for testing our hypothesis. In addition to descriptive statistics, multiple hierarchical regressions and bootstrapping were used to test the study hypotheses.

Findings

Findings suggest that deliberate learning is positively and significantly related with new practice implementation, and dynamic capabilities in the form of task and environmental flexibility mediates this relationship.

Research limitations/implications

The present study makes theoretical and practical contributions by linking literature from new practice, organizational learning and dynamic capabilities; and by delving into the deliberate learning activities undertaken by health-care units.

Originality/value

Organizational learning in health care has almost become inevitable today due to the ever-changing dynamics of the industry. Barring handful of studies, the current state of literature is almost entirely tilted towards experience-based learning and deliberate learning is not well studied. To address this gap, the study aims to develop and test a process model linking development of dynamic capabilities with deliberate learning and new practice implementation. Further, findings of this study will help organizations and managers to understand and thereby effectively manage new practice implementation process through the use of deliberate activities.

Details

Journal of Knowledge Management, vol. 23 no. 6
Type: Research Article
ISSN: 1367-3270

Keywords

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