ArticleBMC health services research2007
The structure of quality systems is important to the process and outcome, an empirical study of 386 hospital departments in Sweden.
Article in BMC health services research, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it, 97 citations in OpenAlex.
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- Patient expectations for management of chronic non-cancer pain: A systematic review.Health expectations : an international journal of public participation in health care and health policy · 2017Pooled it
- Does Value Stream Mapping affect the structure, process, and outcome quality in care facilities? A systematic review.Systematic reviews · 2017Pooled it
- Effectiveness of an internet-based health examination model for focus populations in the Chinese community: a community demonstration trial.International journal for equity in health · 2026Article
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- The development of a performance evaluation index system for Chinese Centers for Disease Control and Prevention: a Delphi consensus study.Global health research and policy · 2024Article
- Cluster of Speaking-Up Behavior in Clinical Nurses and Its Association With Nursing Organizational Culture, Teamwork, and Working Condition: A Cross-Sectional Study.Journal of nursing management · 2024Article
- Interprofessional staff perspectives on the adoption of or black box technology and simulations to improve patient safety: a multi-methods survey.Advances in simulation (London, England) · 2023Article
- A modified Delphi consensus on generic indicators for a low- and middle-income country's quality nursing care measurement.Nursing open · 2022Article
- Impact of the bidirectional relationship between communication and cognitive efficacy on orthopedic patient adherence behavior.BMC health services research · 2022Article
- Outcome Quality of Inpatient and Day-Clinic Treatment in Child and Adolescent Psychiatry-A Naturalistic Study.Children (Basel, Switzerland) · 2021Article
- Article
- A quality-improvement approach to effective trauma team activationCanadian journal of surgery. Journal canadien de chirurgie · 2019Article
- Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario.BMC palliative care · 2019Article
- Development of a System Measurement Model of the Brazilian Hospital Accreditation System.International journal of environmental research and public health · 2018Article
- Perceptions of a group of hospital pharmacists and other professionals of the implementation of clinical pharmacy at a high complexity public hospital in Brazil.BMC health services research · 2018Article
- The association between quality system development stage and the implementation of process-level patient safety themes in Dutch hospitals: an observational study.BMC health services research · 2018Observational
- The Influence of Accreditation on the Sustainability of Organizations with the Brazilian Accreditation Methodology.Journal of healthcare engineering · 2018Article
- Exploring the role of socioeconomic factors in the development and spread of anti-malarial drug resistance: a qualitative study.Malaria journal · 2017Article
- Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model.BMC health services research · 2017Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinicians, nurses, and managers in hospitals are continuously confronted by new technologies and methods that require changes to working practice. Quality systems can help to manage change while maintaining a high quality of care. A new model of quality systems inspired by the works of Donabedian has three factors: structure (resources and administration), process (culture and professional co-operation), and outcome (competence development and goal achievement). The objectives of this study were to analyse whether structure, process, and outcome can be used to describe quality systems, to analyse whether these components are related, and to discuss implications.
methodsA questionnaire was developed and sent to a random sample of 600 hospital departments in Sweden. The adjusted response rate was 75%. The data were analysed with confirmatory factor analysis and structural equation modeling in LISREL. This is to our knowledge the first large quantitative study that applies Donabedian's model to quality systems.
resultsThe model with relationships between structure, process, and outcome was found to be a reasonable representation of quality systems at hospital departments (p = 0.095, indicating no significant differences between the model and the data set). Structure correlated strongly with process (0.72) and outcome (0.60). Given structure, process also correlated with outcome (0.20).
conclusionThe model could be used to describe and evaluate single quality systems or to compare different quality systems. It could also be an aid to implement a systematic and evidence-based system for working with quality improvements in hospital departments.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.