A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol
Author(s)
Type
Journal Article
Abstract
Background: although there is a wealth of information available about quality improvement tools and techniques
in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in
complex organisations like hospitals. The ‘Quality and Safety in Europe by Research’ (QUASER) study will investigate
how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how
they overcome them.
The overall aim of the study is to explore relationships between the organisational and cultural characteristics of
hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers,
payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and
sustain-high quality services for their patients.
Methods/design: in-depth multi-level (macro, meso and micro-system) analysis of healthcare quality policies and
practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The
project design has three major features:
• a working definition of quality comprising three components: clinical effectiveness, patient safety and patient
experience
• a conceptualisation of quality as a human, social, technical and organisational accomplishment
• an emphasis on translational research that is evidence-based and seeks to provide strategic and practical
guidance for hospital practitioners and health care policy makers in the European Union.
Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based,
ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and
quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient
complaints and claims).
Discussion: the protocol is based on the premise that future research, policy and practice need to address the
sociology of improvement in equal measure to the science and technique of improvement, or at least expand the
discipline of improvement to include these critical organisational and cultural processes. We define the
‘organisational and cultural characteristics associated with better quality of care’ in a broad sense that encompasses
all the features of a hospital that might be hypothesised to impact upon clinical effectiveness, patient safety and/or
patient experience.
in healthcare there is little understanding about overcoming the challenges of day-to-day implementation in
complex organisations like hospitals. The ‘Quality and Safety in Europe by Research’ (QUASER) study will investigate
how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how
they overcome them.
The overall aim of the study is to explore relationships between the organisational and cultural characteristics of
hospitals and how these impact on the quality of health care; the findings will be designed to help policy makers,
payers and hospital managers understand the factors and processes that enable hospitals in Europe to achieve-and
sustain-high quality services for their patients.
Methods/design: in-depth multi-level (macro, meso and micro-system) analysis of healthcare quality policies and
practices in 5 European countries, including longitudinal case studies in a purposive sample of 10 hospitals. The
project design has three major features:
• a working definition of quality comprising three components: clinical effectiveness, patient safety and patient
experience
• a conceptualisation of quality as a human, social, technical and organisational accomplishment
• an emphasis on translational research that is evidence-based and seeks to provide strategic and practical
guidance for hospital practitioners and health care policy makers in the European Union.
Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based,
ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and
quantitative research (secondary analysis of safety and quality data, for example: adverse incident reporting; patient
complaints and claims).
Discussion: the protocol is based on the premise that future research, policy and practice need to address the
sociology of improvement in equal measure to the science and technique of improvement, or at least expand the
discipline of improvement to include these critical organisational and cultural processes. We define the
‘organisational and cultural characteristics associated with better quality of care’ in a broad sense that encompasses
all the features of a hospital that might be hypothesised to impact upon clinical effectiveness, patient safety and/or
patient experience.
Date Issued
2011-10-26
Date Acceptance
2011-10-26
Citation
BMC Health Services Research, 2011, 11
ISSN
1472-6963
Publisher
BioMed Central
Journal / Book Title
BMC Health Services Research
Volume
11
Copyright Statement
© 2011 Robert et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.
License URL
Sponsor
Commission of the European Communities
Grant Number
241724
Subjects
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
HEALTH CARE SCIENCES & SERVICES
CARE
CLIMATE
ORGANIZATIONS
IMPROVEMENT
Publication Status
Published
Article Number
285