This translational study will produce an evidence-based guide for hospitals for implementing quality and safety improvement, and a framework for payers to assess the quality and safety of hospitals across the EU. The study will take place in five European countries: the Netherlands, Norway, Portugal, Sweden, and England. The study will compare the macro-level (national) healthcare contexts of the countries and identify the hospital characteristics and cultures that are associated with quality at the organisational and clinical microsystem levels. We will investigate in depth how hospitals implement, spread and sustain quality improvement programmes, including the difficulties they faced and how they were overcome. Our study will seek to understand the differences between high and low performing hospitals in terms of organisational factors such as culture, leadership and management structures.
Although there is a wealth of information available about quality improvement methods in healthcare there is little guidance available about overcoming the challenges of implementation in a complex healthcare organisation. Guidance needs to be grounded in the realities and constraints of healthcare practice. This project will therefore address a significant need in the healthcare sector by providing guidance drawn from the everyday experiences of hospitals in the EU.
In many EU countries there is acknowledgement of the need for payers to assess the quality of the healthcare they purchase. Building quality into purchasing decisions could be a powerful way to improve healthcare quality. However assessing quality is not straightforward because there are many outcome indicators of quality but little guidance about how reliable and valid these indicators are. There is a need for organisational process indicators to inform purchasing decisions. This project will therefore provide guidance for both payers and hospital managers.
The overall aim of the QUASER study is to explore the relationships between the organisational and cultural characteristics of hospitals, and how these impact upon clinical effectiveness, patient safety and patient experience in European Union countries.
Specifically, the findings will be used
These outputs will be based on empirical findings from research in five partner countries. However, in addition, and most crucially, the development of these outputs will be with our wider stakeholder group of 7 countries, through a parallel process of translational workshops involving both hospitals and payers from these countries.
The Guide and Framework will be disseminated to hospital managers and payers across Europe to facilitate improvement of the quality of hospital care.