International Journal for Quality in Health Care Advance Access originally published online on February 2, 2007
International Journal for Quality in Health Care 2007 19(2):90-104; doi:10.1093/intqhc/mzl071
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Performance improvement based on integrated quality management models: what evidence do we have? A systematic literature review
1 Dutch Institute for Healthcare Improvement CBO, Utrecht, The Netherlands
2 University of Groningen, Faculty of Management and Organization, Groningen, The Netherlands
3 Erasmus University Rotterdam, Institute of Health Policy and Management, Rotterdam, The Netherlands
Purpose. Health care organizations have to improve their performance for multiple stakeholders and organize integrated care. To facilitate this, various integrated quality management models can be used. This article reviews the literature on the Malcolm Baldrige Quality Award (MBQA) criteria, the European Foundation Quality Management (EFQM) Excellence model (Excellence award models) and the Chronic Care Model. The focus is on the empirical evidence for improved performance by the implementation of interventions based on these models.
Data sources. A systematic literature review from 1995 to May 2006 in the Pubmed, Cochrane, and ABI- databases was conducted.
Study selection. After selection, 37 studies were included, 16 in the Excellence award model search and 21 in the Chronic Care Model search.
Data extraction and results of analysis. Data were retrieved about the main intervention elements, study design, evidence level, setting and context factors, data collection and analysis, principal results and performance dimensions. No Excellence Award model studies with controlled designs were found. For the Chronic Care Model, one systematic review, one meta analysis and six controlled studies were included. Seventeen studies (2 in Excellence award model, 15 in Chronic Care Model) reported one or more significant results.
Conclusion. There is some evidence that implementing interventions based on the ‘evidence-based developed’ Chronic Care Model may improve process or outcome performances. The evidence for performance improvement by interventions based on the ‘expert-based developed’ MBQA criteria and the EFQM Excellence model is more limited. Only a few studies include balanced measures on multiple performance dimensions. Considering the need for integrated care and chronic care improvement, the further development of these models for guiding improvements in integrated care settings and their specific context factors is suggested.
Keywords: performance improvement, total quality management, chronic disease, organizational models, evidence-based
Address reprint requests to Mirella Minkman, Dutch Institute for Healthcare Improvement CBO, Churchilllaan 11, 3502 LB Utrecht, The Netherlands. Tel: +31-30-2843962; Fax: +31-30-2943644; E-mail: m.minkman{at}cbo.nl
Accepted for publication December 9, 2006.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  O. Groene, E. Brandt, W. Schmidt, and J. Moeller The Balanced Scorecard of acute settings: development process, definition of 20 strategic objectives and implementation Int. J. Qual. Health Care, August 1, 2009; 21(4): 259 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D Agins and M. M Holden Defining a high performance healthcare organisation BMJ, November 24, 2007; 335(7629): 1055 - 1056. [Full Text] [PDF]
|
|