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Enacting quality im...
Enacting quality improvement in ten European hospitals : a dualities approach
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- Nunes, Francisco G. (författare)
- ISCTE-IUL, Lisbon University Institute, BRU-IUL, Avenida das Forças Armadas, Lisbon, Portugal
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- Robert, Glenn (författare)
- King's College London, London, United Kingdom
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- Weggelaar-Jansen, Anne Marie (författare)
- iBMG - Erasmus University Rotterdam, Rotterdam, Netherlands
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- Wiig, Siri (författare)
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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- Aase, Karina (författare)
- SHARE-Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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- Karltun, Anette, 1956- (författare)
- Jönköping University,The Jönköping Academy for Improvement of Health and Welfare,JTH, Logistik och verksamhetsledning
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- Fulop, Naomi J. (författare)
- Department of Applied Health Research, University College London, London, United Kingdom
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(creator_code:org_t)
- 2020-07-16
- 2020
- Engelska.
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
- Relaterad länk:
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https://doi.org/10.1...
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https://bmchealthser...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Hospitals undertake numerous initiatives searching to improve the quality of care they provide, but these efforts are often disappointing. Current models guiding improvement tend to undervalue the tensional nature of hospitals. Applying a dualities approach that is sensitive to tensions inherent to hospitals' quest for improved quality, this article aims to identify which organizational dualities managers should particularly pay attention to.METHODS: A set of cross-national, multi-level case studies was conducted involving 383 semi-structured interviews and 803 h of non-participant observation of key meetings and shadowing of staff in ten purposively sampled hospitals in five European countries (England, the Netherlands, Portugal, Sweden, and Norway).RESULTS: Six dualities that describe the quest for improved quality, each embracing a seemingly contradictory feature were identified: plural consensus, distributed connectedness, orchestrated emergence, formalized fluidity, patient coreness, and cautious generativeness.CONCLUSIONS: We advocate for a move from the usual sequential and project-based and systemic thinking about quality improvement to the development of meta-capabilities to balance the simultaneous operation of opposing ideas or concepts. Doing so will help hospital managers to deal with major challenges of change inherent to quality improvement initiatives.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Nyckelord
- Dualities
- Organizational change
- Paradoxes
- Quality improvement
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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