Failure factors in healthcare quality improvement programmes: reviewing two decades of the scientific field

Abstract

Purpose

Quality improvement is imperative for healthcare organisations. Despite the importance of the topic, many efforts have been wasted on failed improvement programs. Various studies have tried to identify the failure factors in improvement programs, but the divergences in the results hamper this research field’s evolution. This study reviews scientific activity from 2000 to 2019 on failure factors in Healthcare Quality Improvement Programs (HCQIP) to help academics and managers understand the field’s evolution better. This research intends to answer four questions on failure factors in HCQIP: Who are the most active authors in this field?; Which journals have been used as diffusion channels?; What are the themes addressed the most in this field?; and What are the themes considered to be emerging?

Design/methodology/approach

The authors conducted a bibliometric-based literature review on a sample of 5,137 articles, and 104 studies were included in this review, covering a longitudinal analysis in two periods (P1: 2000–2010 and P2: 2011–2019). Performance analysis, citation, co-citation, co-words analysis and network mapping identified the authors in this scientific field, the journals, the number of articles, along with the current and emerging themes that reveal the latent structure of the factors associated with failures in HCQIP.

Findings

The number of articles in P2 (83 studies) is almost four times higher than in P1 (21 studies). The results reveal a dynamic field attracting more authors since 2013, expanding from 5 to 42 journals that publish on the topic. Furthermore, research has evolved from comprehensive manufacturing programs to more theory-based and contextualised health care. In this sense, the recent literature (P2) suggests that failure factors related to quality improvement programs can be minimised if these initiatives align with the human centrality paradigm.

Practical implications

Analysing the evolution of failure factors in HCQIP helps redesign research and management for better quality health outcomes. Knowledge of the scientific community trajectory over nearly 20 years enables better planning from the patient's perspective and contributes to reducing failures in quality programs.

Originality/value

This study contributes to developing the field of failure factors in HCQIP by providing researchers and managers with an evolutionary, systematic and pioneering view of the theme.