Journal
QUALITY MANAGEMENT IN HEALTH CARE
Volume 22, Issue 2, Pages 86-99Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QMH.0b013e31828bc37d
Keywords
health services management; organizational change; organizational improvement; organizational learning; performance improvement; quality improvement
Funding
- Swedish Foundation for International Collaboration in Research and Higher Education (STINT)
- Agency for Healthcare Research Quality (AHRQ)
- Swedish Association of Local Authorities and Regions (SKL)
- Vinnvard research program in Sweden [A2007034]
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Objective: We sought to improve our understanding of how health care quality improvement (QI) methods and innovations could be efficiently and effectively translated between settings to reduce persistent gaps in health care quality both within and across countries. We aimed to examine whether we could identify a core set of organizational cultural attributes, independent of context and setting, which might be associated with success in implementing and sustaining QI systems in health care organizations. Methods: We convened an international group of investigators to explore the issues of organizational culture and QI in different health care contexts and settings. This group met in person 3 times and held a series of conference calls to discuss emerging ideas over 2 years. Investigators also conducted pilot studies in their home countries to examine the applicability of our conceptual model. Results and Conclusions: We suggest that organizational coherence may be a critical element of QI efforts in health care organizations and propose that there are 3 key components of organizational coherence: (1) people, (2) processes, and (3) perspectives. Our work suggests that the concept of organizational coherence embraces both culture and context and can thus help guide both researchers and practitioners in efforts to enhance health care QI efforts, regardless of organizational type, location, or context.
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