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Article
Publication date: 15 March 2013

Edward Broughton, Zakari Saley, Maina Boucar, Dondi Alagane, Kathleen Hill, Aicha Marafa, Yaroh Asma and Karimou Sani

The purpose of this paper is to describe a quality improvement collaborative conducted in 33 Nigerian facilities to improve maternal and newborn care outcomes by increasing…

Abstract

Purpose

The purpose of this paper is to describe a quality improvement collaborative conducted in 33 Nigerian facilities to improve maternal and newborn care outcomes by increasing compliance with high‐impact, evidence‐based care standards. Intervention costs and cost‐effectiveness were examined and costs to the Niger Health Ministry (MoH) were estimated if they were to scale‐up the intervention to additional sites.

Design/methodology/approach

Facility‐based maternal care outcomes and costs from pre‐quality improvement collaborative baseline monitoring data in participating facilities from January to May 2006 were compared with outcomes and costs from the same facilities from June 2008 to September 2008. Cost data were collected from project accounting records. The MoH costs were determined from interviews with clinic managers and quality improvement teams. Effectiveness data were obtained from facilities' records.

Findings

The average delivery‐cost decreased from $35 before to $28 after the collaborative. The USAID/HCI project's incremental cost was $2.43/delivery. The collaborative incremental cost‐effectiveness was $147/disability‐adjusted life year averted. If the MoH spread the intervention to other facilities, substantive cost‐savings and improved health outcomes can be predicted.

Practical implications

The intervention achieved significant positive health benefits for a low cost. The Niger MoH can expect approximately 50 per cent return on its investment if it implements the collaborative in new facilities. The improvement collaborative approach can improve health and save health care resources.

Originality/value

This is one of the first studies known to examine collaborative quality improvement and economic efficiency in a developing country.

Details

International Journal of Health Care Quality Assurance, vol. 26 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 4 July 2016

Elizabeth van Veen-Berkx, Dirk F. de Korne, Olivier S. Olivier, Roland A. Bal and Geert Kazemier

Benchmarking is increasingly considered a useful management instrument to improve performance in healthcare. The purpose of this paper is to assess if a nationwide long-term…

1688

Abstract

Purpose

Benchmarking is increasingly considered a useful management instrument to improve performance in healthcare. The purpose of this paper is to assess if a nationwide long-term benchmarking collaborative between operating room (OR) departments of university medical centres in the Netherlands leads to benefits in OR management and to evaluate if the initiative meets the requirements of the 4P-model.

Design/methodology/approach

The evaluation was based on the 4P-model (purposes, performance indicators, participating organisations, performance management system), developed in former studies. A mixed-methods design was applied, consisting of document study, observations, interviews as well as analysing OR performance data using SPSS statistics.

Findings

Collaborative benchmarking has benefits different from mainly performance improvement and identification of performance gaps. It is interesting that, since 2004, the OR benchmarking initiative still endures after already existing for ten years. A key benefit was pointed out by all respondents as “the purpose of networking”, on top of the purposes recognised in the 4P-model. The networking events were found to make it easier for participants to contact and also visit one another. Apparently, such informal contacts were helpful in spreading knowledge, sharing policy documents and initiating improvement. This benchmark largely met all key conditions of the 4P-model.

Research limitations/implications

The current study has the limitations accompanied with any qualitative research and particularly related to interviewing. Qualitative research findings must be viewed within the context of the conducted case study. The experiences in this university hospital context in the Netherlands might not be transferable to other (general) hospital settings or other countries. The number of conducted interviews is restricted; nevertheless, all other data sources are extensive.

Originality/value

A collaborative approach in benchmarking can be effective because participants use its knowledge-sharing infrastructure which enables operational, tactical and strategic learning. Organisational learning is to the advantage of overall OR management. Benchmarking seems a useful instrument in enabling hospitals to learn from each other, to initiate performance improvements and catalyse knowledge-sharing.

Article
Publication date: 28 January 2019

Kieran Mervyn, Nii Amoo and Rebecca Malby

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the…

1067

Abstract

Purpose

Public sectors have responded to grand societal challenges by establishing collaboratives – new inter-organizational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to enhance the value of investments in quality improvement programs. The nature and organizational form of such improvements is still a subject of debate within the public-sector literature. Place-based collaboration has been proposed as a possible solution. In response, the purpose of this study is to present the results and findings of a place-based collaborative network, highlighting challenges and insights.

Design/methodology/approach

This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used and data collected in three different stages over a two-year period.

Findings

The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality.

Research limitations/implications

Regardless of the tensions and challenges with place-based networks, they could still be a solution in maximizing the public value required by government investments in the healthcare sector, as they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This study is limited by the use of a single case study.

Practical implications

Across countries health systems are moving away from markets to collaborative models for healthcare delivery and from individual services to population-based approaches. This study provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations.

Social implications

As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This study provides insights into the new partnership between health institutions and communities, providing opportunities for more social- and solidarity-based healthcare models which place patients and the public at the heart of change.

Originality/value

The city place-based network is the first of such organizational form in healthcare collaboration in the UK.

Details

International Journal of Organizational Analysis, vol. 27 no. 4
Type: Research Article
ISSN: 1934-8835

Keywords

Article
Publication date: 20 May 2020

Rowena Catipay Buyan, Jill Aylott and Duncan Carratt

Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the capacity in…

Abstract

Purpose

Over half of adults under the age of 65 years will be diagnosed with cancer at some point in their lives (Ahmad et al., 2015). Demand for services is outstripping the capacity in the NHS, as 77% of NHS Trusts are unable to start treatment within 62 days (Baker, 2019; NHS England, 2019). Side effects of treatment can be life threatening (Tsai et al., 2010) with many patients attending ED; however, these can be managed through a hospital’s Acute Oncology Service (AOS). This paper aims to explore a collaborative leadership approach to improve services for patients [Rubin et al., 2015; Department of Health (DOH), 2012].

Design/methodology/approach

A case study of an AOS in an NHS Trust was the focus for the development of a strategy of ‘Collaborative’ leadership, with the aim to increase the engagement of a wide network of clinical and non-clinical stakeholders in a review of the AOS. The case study identified the level of effectiveness of the service since its inception in 2012. Using a quality improvement methodology (Deming 2000; Health Foundation, 2011; Aylott, 2019) resulted in learning and increased collaboration between clinical and non-clinical staff.

Findings

Action learning processes revealed that AOS staff had been frustrated for some time about the dysfunction of the current process to manage the increased demand for the service. They reported their perceptions and frustrations with the current process of referral and patient discharge. Data revealed alerts from the Emergency Department (ED) to AOS resulted in 72% of patients inappropriately referred, with an over representation of patients who had a previous existing cancer condition. Clinical engagement with the data informatics manager (DC) revealed a need to improve data quality through improvements made to the database.

Research limitations/implications

Increasing demand for cancer services requires a continuous need for improvement to meet patient needs. Cancer waits for diagnostic tests are at their highest level since 2008, with 4% of patients waiting over 6 weeks to be tested compared to the tested target of 1% (Baker, 2019). This paper draws on data collected from 2017 to 2018, but a continuous review of data is required to measure the performance of the AOS against its service specification. Every AOS team across the NHS could benefit from a collaborative learning approach.

Practical implications

Clinical services need collaborative support from informatics to implement a Quality Improvement methodology such as the IHI Model for Improvement (IHI, 2003). Without collaboration the implementation of a quality improvement strategy for all NHS Trusts will not come to fruition (Kings Fund, 2016). Quality Improvement Strategies must be developed with a collaborative leadership implementation plan that includes patient collaboration strategies (Okpala, 2018), as this is the only way that services will be improved while also becoming cost effective (Okpala, 2018).

Social implications

In the UK, 20-25% of new cancer diagnoses are made following an initial presentation to the ED (Young et al., 2016). Cancer-related attendances at ED had a higher level of acuity, requiring longer management time and length of stay in ED. With cancer care contributing to 12% of all hospital admissions, an increase of 25% over the past two decades (Kuo et al., 2017) the AOS will need continued collaboration between clinical staff, informatic managers, patients and all stakeholder organisations to continuously improve its services to be “fit for purpose”.

Originality/value

This case study reports the innovative collaborative work between a Medical Oncologist, an NHS Trust Informatics manager and a QI academic facilitator. The Health Foundation and Kings Fund have identified the continued challenges presented to the NHS in the transformation of its services, with the Health Foundation (2011) reporting the need for more collaborative working between clinicians and non-clinicians to drive improvement. This model of collaboration creates a new way of working to drive improvement initiatives and sets out a rationale to develop this model further to involve patients. However, this will call for a new way of working for all.

Details

Leadership in Health Services, vol. 33 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 3 October 2022

Sharon J. Williams, Lynne Caley, Mandy Davies, Dominique Bird, Sian Hopkins and Alan Willson

Quality improvement collaboratives (QICs) are a popular approach to improving healthcare services and patient outcomes. This paper evaluates a QIC implemented by a large…

Abstract

Purpose

Quality improvement collaboratives (QICs) are a popular approach to improving healthcare services and patient outcomes. This paper evaluates a QIC implemented by a large, integrated healthcare organisation in Wales in the UK.

Design/methodology/approach

This evaluation study draws on two well-established evaluation frameworks: Kirkpatrick's approach to gather data on participant satisfaction and learning and Stake's approach to gather data and form judgements about the impact of the intervention. A mixed methods approach was taken which included documentary analysis, surveys, semi-structured interviews, and observation of the QIC programme.

Findings

Together the two frameworks provide a rounded interpretation of the extent to which the QIC intervention was fit-for-purpose. Broadly the evaluation of the QIC was positive with some areas of improvement identified.

Research limitations/implications

This study is limited to a QIC conducted within one organisation. Further testing of the hybrid framework is needed that extends to different designs of QICs.

Practical implications

A hybrid framework is provided to assist those charged with designing and evaluating QICs.

Originality/value

Evaluation studies are limited on QICs and if present tend to adopt one framework. Given the complexities of undertaking quality improvement within healthcare, this study uniquely takes a hybrid approach.

Details

Journal of Health Organization and Management, vol. 36 no. 8
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 13 March 2009

Mikihisa Nakano

The purpose of this paper is to empirically examine the impact of internal and external collaborative forecasting and planning on logistics and production performance.

5680

Abstract

Purpose

The purpose of this paper is to empirically examine the impact of internal and external collaborative forecasting and planning on logistics and production performance.

Design/methodology/approach

To measure the degree of collaborative forecasting and planning, the concept of collaboration is categorized into three dimensions: sharing resources, collaborative process operation, and collaborative process improvement. Based on these dimensions, a survey of Japanese manufacturers was conducted and the analytical model is proposed to examine using structural equation modeling.

Findings

There are positive relationships between internal and external collaborative forecasting and planning. Upstream and downstream collaborative forecasting and planning are also positively related. Internal collaborative forecasting and planning has a positive effect on relative logistics and production performance. External collaborative forecasting and planning does not have a significant effect on relative logistics and production performance.

Research limitations/implications

This study does not clarify how firms can achieve the improvement of forecasting and planning process. Future research should investigate the mechanism of process improvement in supply chain.

Practical implications

Not only sharing resources and collaborative process operation but also collaborative process improvement play a crucial role in gaining sustainable competitive advantage in logistics and production.

Originality/value

This study focuses on the forecasting and planning process in supply chain and proposes new dimensions measuring the degree of collaborative forecasting and planning. By focusing on the process and using the dimensions, the relationship between supply chain collaboration and performance are discussed concretely.

Details

International Journal of Physical Distribution & Logistics Management, vol. 39 no. 2
Type: Research Article
ISSN: 0960-0035

Keywords

Article
Publication date: 1 July 2002

Sarah Fraser, Tim Wilson, Ken Burch, Mary‐Ann Osborne and Martin Knightley

Improvements were delivered in the care of patients on anti‐coagulants through a collaborative improvement methodology within one primary care organisation. Although a key…

Abstract

Improvements were delivered in the care of patients on anti‐coagulants through a collaborative improvement methodology within one primary care organisation. Although a key clinical governance priority, the project was conducted in a low‐key manner with minimal support. Practice teams were encouraged to apply evidence through small‐scale testing of changes, using measurements to monitor improvement and to share what they learned amongst themselves. No specific model of care was pursued and instead the emphasis was on demonstrating an improvement at the practice level, by whatever means worked best. The methodology used was similar to that applied in major national and regional collaborative programmes. This project demonstrates how it can be simplified and implemented within one primary care organisation to deliver improvements in care as well as to support the building of teams and learning about measurement and quality improvement.

Details

International Journal of Health Care Quality Assurance, vol. 15 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 March 2006

David Coghlan and Paul Coughlan

The purpose of this article is to provide a design and implementation framework for ALAR (action learning action research) programme which aims to address collaborative improvement

1186

Abstract

Purpose

The purpose of this article is to provide a design and implementation framework for ALAR (action learning action research) programme which aims to address collaborative improvement in the extended manufacturing enterprise.

Design/methodology/approach

This article demonstrates the design of a programme in which action learning and action research were used in combination (ALAR). The participants in the EME engaged in action learning on their work on collaborative improvement in the supply chain. The action learning was studied through action research cycles of action and reflection.

Findings

This implementation of the ALAR programme consolidated the design of ten meetings across three stages and adds to other design models within ALAR approach.

Research limitations/implications

This is one particular research programme, from which learning may be extrapolated.

Practical implications

This article provides a practical design framework for ALAR programmes on collaborative improvement in the EME.

Originality/value

The article extends the application of an ALAR programme design into the inter‐organisational setting.

Details

The Learning Organization, vol. 13 no. 2
Type: Research Article
ISSN: 0969-6474

Keywords

Article
Publication date: 20 November 2017

Gergana Staykova and Jason Underwood

How knowledge exchange (KE) can be used for the continuous assessment and improvement of collaborative performance of project-based organisations in construction is explored…

Abstract

Purpose

How knowledge exchange (KE) can be used for the continuous assessment and improvement of collaborative performance of project-based organisations in construction is explored. Collaboration on construction projects must be facilitated by people alongside practice of continuous performance assessment and improvement. Currently available assessment tools fail to explicitly define appropriate behaviours and actions due to a poor understanding of what it means for people to collaborate. In contrast, it is established that KE is the focus of collaborative efforts on construction projects; therefore, as most knowledge resides with people, it represents their role in collaboration. The paper aims to discuss these issues.

Design/methodology/approach

Through a phenomenological/interpretivist and qualitative methodology, how KE can be used for the continuous assessment and improvement of collaborative performance in project-based organisations in construction is explored. A single case study of a UK rail strategic alliance was adopted and six semi-structured interviews were conducted and analysed through a thematic analysis.

Findings

An assessment tool is proposed based on a set of 20 characteristics of KE, divided into seven categories and linked to indicators of collaboration. The tool can be applied to highly collaborative projects where BIM and Lean are implemented, and project participants are collocated. By measuring their performance against the set criteria, project teams can assess which of their behaviours and actions are inappropriate, and focus their efforts on correcting them.

Originality/value

Defining the abstract indicators traditionally used to assess collaboration in terms of characteristics pertinent to day-to-day communication amongst participants on collaborative projects to facilitate the continuous assessment and improvement of collaborative performance.

Details

Engineering, Construction and Architectural Management, vol. 24 no. 6
Type: Research Article
ISSN: 0969-9988

Keywords

Article
Publication date: 28 March 2023

David H. Eddy-Spicer

Follett's relational process theory illuminates key aspects of interdependence among organizations in the field of education that are essential to fostering capacities for…

Abstract

Purpose

Follett's relational process theory illuminates key aspects of interdependence among organizations in the field of education that are essential to fostering capacities for interorganizational resilience. The article argues for the necessity of developing mutualism in systems of education as essential preparation for times of instability and crisis, as demonstrated through recent experiences with the COVID-19 pandemic.

Design/methodology/approach

This article provides an introduction to the relational process theory of Mary Parker Follett, a foundational theorist of organizing and administration. This theoretical review uses worked examples drawn from a collaborative, continuous improvement partnership focused on educational leadership preparation and development.

Findings

The author identifies four aspects of Follett's theory that connect most directly to collaborative, continuous improvement partnerships. These include mutualism as circular response, coactive power, embrace of difference through constructive conflict and integrating experience through learning. The article discusses how these offer an integrated framework of foundational concepts for nurturing and sustaining educational systems capable of adaptive change in the face of complex challenges.

Originality/value

Follett's relational process theory offers a perspective on partnering as a dynamic and evolving constellation of interactions and activity. The implications of Follett's core ideas for education resonate beyond improvement partnerships and offer guidance at all levels of educational systems seeking to orient towards an evolutionary logic.

Details

Journal of Educational Administration, vol. 61 no. 3
Type: Research Article
ISSN: 0957-8234

Keywords

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