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

Hdl Handle:
http://hdl.handle.net/10147/263240
Title:
A 10 year (2000--2010) systematic review of interventions to improve quality of care in hospitals
Authors:
Conry, Mary C; Humphries, Niamh; Morgan, Karen; McGowan, Yvonne; Montgomery, Anthony; Vedhara, Kavita; Panagopoulou, Efharis; Mc Gee, Hannah
Citation:
BMC Health Services Research. 2012 Aug 24;12(1):275
Issue Date:
24-Aug-2012
URI:
http://dx.doi.org/10.1186/1472-6963-12-275; http://hdl.handle.net/10147/263240
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.
Item Type:
Journal Article

Full metadata record

DC FieldValue Language
dc.contributor.authorConry, Mary C-
dc.contributor.authorHumphries, Niamh-
dc.contributor.authorMorgan, Karen-
dc.contributor.authorMcGowan, Yvonne-
dc.contributor.authorMontgomery, Anthony-
dc.contributor.authorVedhara, Kavita-
dc.contributor.authorPanagopoulou, Efharis-
dc.contributor.authorMc Gee, Hannah-
dc.date.accessioned2012-12-19T11:43:31Z-
dc.date.available2012-12-19T11:43:31Z-
dc.date.issued2012-08-24-
dc.identifier.citationBMC Health Services Research. 2012 Aug 24;12(1):275-
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-12-275-
dc.identifier.urihttp://hdl.handle.net/10147/263240-
dc.description.abstractBackground 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.-
dc.titleA 10 year (2000--2010) systematic review of interventions to improve quality of care in hospitals-
dc.typeJournal Article-
dc.language.rfc3066en-
dc.rights.holderMary C Conry et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2012-12-17T12:06:46Z-
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