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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

A 10 year (2000–2010) systematic review of interventions to improve quality of care in hospitals

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2012
Autoren:
Mary C Conry, Niamh Humphries, Karen Morgan, Yvonne McGowan, Anthony Montgomery, Kavita Vedhara, Efharis Panagopoulou, Hannah Mc Gee
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-275) contains supplementary material, which is available to authorized users.

Competing Interest

The authors declare that they have no competing interests.

Abstract

Background

Against a backdrop of rising healthcare costs, variability in care provision and an increased emphasis on patient satisfaction, the need for effective interventions to improve quality of care has come to the fore. This is the first ten year (2000–2010) systematic review of interventions which sought to improve quality of care in a hospital setting. This review moves beyond a broad assessment of outcome significance levels and makes recommendations for future effective and accessible interventions.

Methods

Two researchers independently screened a total of 13,195 English language articles from the databases PsychInfo, Medline, PubMed, EmBase and CinNahl. There were 120 potentially relevant full text articles examined and 20 of those articles met the inclusion criteria.

Results

Included studies were heterogeneous in terms of approach and scientific rigour and varied in scope from small scale improvements for specific patient groups to large scale quality improvement programmes across multiple settings. Interventions were broadly categorised as either technical (n = 11) or interpersonal (n = 9). Technical interventions were in the main implemented by physicians and concentrated on improving care for patients with heart disease or pneumonia. Interpersonal interventions focused on patient satisfaction and tended to be implemented by nursing staff. Technical interventions had a tendency to achieve more substantial improvements in quality of care.

Conclusions

The rigorous application of inclusion criteria to studies established that despite the very large volume of literature on quality of care improvements, there is a paucity of hospital interventions with a theoretically based design or implementation. The screening process established that intervention studies to date have largely failed to identify their position along the quality of care spectrum. It is suggested that this lack of theoretical grounding may partly explain the minimal transfer of health research to date into policy. It is recommended that future interventions are established within a theoretical framework and that selected quality of care outcomes are assessed using this framework. Future interventions to improve quality of care will be most effective when they use a collaborative approach, involve multidisciplinary teams, utilise available resources, involve physicians and recognise the unique requirements of each patient group.
Zusatzmaterial
Additional file 1: Search Strategy results.(XLS 24 KB)
12913_2012_2311_MOESM1_ESM.xls
Authors’ original file for figure 1
12913_2012_2311_MOESM2_ESM.pdf
Authors’ original file for figure 2
12913_2012_2311_MOESM3_ESM.doc
Authors’ original file for figure 3
12913_2012_2311_MOESM4_ESM.doc
Literatur
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