Factors driving differences in the adoption of quality management practices among hospitals: A two-phase, sequential mixed-methods analysis.

IF 1.7 3区医学 Q3 HEALTH POLICY & SERVICES

Health Care Management Review Pub Date : 2024-07-01 Epub Date: 2024-05-03 DOI:10.1097/HMR.0000000000000402

Fenja Hoogestraat, Eva-Maria Wild, Vera Winter

{"title":"Factors driving differences in the adoption of quality management practices among hospitals: A two-phase, sequential mixed-methods analysis.","authors":"Fenja Hoogestraat, Eva-Maria Wild, Vera Winter","doi":"10.1097/HMR.0000000000000402","DOIUrl":null,"url":null,"abstract":"Background: Although all hospitals aim to deliver high-quality care, there is considerable variation in their adoption of quality management (QM) practices. Organizational and environmental factors are known to drive strategic decision-making in hospitals, but their impact on the adoption of QM practices remains unclear.Purpose: Our study aims to identify multiple organizational and environmental factors that explain variation in the adoption of QM practices among hospitals and to explore mechanisms underlying these relationships.Methodology: We conducted a two-phase, sequential mixed-methods study of German acute care hospitals. The quantitative phase used between-effects regressions to identify factors explaining variation in the number of QM practices adopted by hospitals from 2015 to 2019. The qualitative phase used semistructured interviews with quality managers to gain in-depth insights.Results: The number of QM practices adopted by a hospital was significantly associated with factors like hospital size and the presence of an emergency department or QM steering committee. Our qualitative findings highlighted potential mechanisms such as the presence of an emergency department serving as a proxy for organizational complexity or urgency of case-mix.Conclusion: We provide an overview of factors driving QM adoption in hospitals, extending beyond the focus on single factors in previous research. Future studies could explore additional factors highlighted by our interviewees.Practice implications: Our results can inform interventions to strengthen QM in hospitals and guide future research on this topic.","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"161-175"},"PeriodicalIF":1.7000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Care Management Review","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/HMR.0000000000000402","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/3 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Although all hospitals aim to deliver high-quality care, there is considerable variation in their adoption of quality management (QM) practices. Organizational and environmental factors are known to drive strategic decision-making in hospitals, but their impact on the adoption of QM practices remains unclear.

Purpose: Our study aims to identify multiple organizational and environmental factors that explain variation in the adoption of QM practices among hospitals and to explore mechanisms underlying these relationships.

Methodology: We conducted a two-phase, sequential mixed-methods study of German acute care hospitals. The quantitative phase used between-effects regressions to identify factors explaining variation in the number of QM practices adopted by hospitals from 2015 to 2019. The qualitative phase used semistructured interviews with quality managers to gain in-depth insights.

Results: The number of QM practices adopted by a hospital was significantly associated with factors like hospital size and the presence of an emergency department or QM steering committee. Our qualitative findings highlighted potential mechanisms such as the presence of an emergency department serving as a proxy for organizational complexity or urgency of case-mix.

Conclusion: We provide an overview of factors driving QM adoption in hospitals, extending beyond the focus on single factors in previous research. Future studies could explore additional factors highlighted by our interviewees.

Practice implications: Our results can inform interventions to strengthen QM in hospitals and guide future research on this topic.

查看原文本刊更多论文

推动医院采用质量管理方法差异的因素：两阶段顺序混合方法分析。

背景：尽管所有医院都以提供高质量的医疗服务为目标，但在采用质量管理（QM）实践方面却存在着相当大的差异。众所周知，组织和环境因素是医院战略决策的驱动力，但它们对采用质量管理方法的影响仍不明确。研究目的：我们的研究旨在确定多种组织和环境因素，以解释医院在采用质量管理方法方面的差异，并探索这些关系的内在机制：我们对德国急症护理医院进行了一项分两个阶段、按顺序进行的混合方法研究。在定量研究阶段，我们使用效应间回归法来确定解释 2015 年至 2019 年期间医院采用 QM 实践数量变化的因素。定性阶段则对质量管理人员进行了半结构化访谈，以获得深入的见解：结果：医院采用的质量管理实践数量与医院规模、急诊科或质量管理指导委员会的存在等因素密切相关。我们的定性研究结果强调了潜在的机制，如急诊科的存在可代表组织的复杂性或病例组合的紧迫性：我们概述了推动医院采用质量管理的因素，超越了以往研究对单一因素的关注。未来的研究可以探讨受访者强调的其他因素：实践意义：我们的研究结果可为加强医院质量管理的干预措施提供参考，并为今后有关该主题的研究提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Health Care Management Review HEALTH POLICY & SERVICES-

CiteScore

4.70

自引率

8.00%

发文量

期刊介绍： Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.