Studying quality and safety in hospitals by using different theoretical models - Does it matter?

Siri Wiig, Karina Aase, Elina Pietikainen, Teemu Reiman, Luigi Macchi, Janet Anderson, Glenn Robert

Research output: Chapter in Book/Report/Conference proceedingConference PaperResearchpeer-review

Abstract

A number of theoretical models can be applied to guide quality improvement (QI) and patient safety work in hospitals. However there are often significant differences between them and, therefore, their likely relative contribution when applied in diverse contexts. In this paper we describe and compare two different theoretical models: 1) the Organizing for Quality Model (OQ) (Bate, Mendel & Robert, 2008) and 2) the Design for Integrated Safety Culture Model (DISC) (Reiman, Pietikainen, & Oedewald, 2009). The objective of the paper is to conduct an exploratory analysis of the contributions that each of the models can make to our overall understanding of how hospitals organize for - and improve - quality and safety. The OQmodel describes six universal challenges (structural, political, cultural, educational, emotional, and physical/technological) hospitals need to address locally in order to improve quality. The DISC-model describes the criteria for good safety culture and organizational functions necessary for developing good safety culture (e.g. values, complexity, core tasks, mindfulness, responsibility, and organizing). Our theoretical analysis of the two models OQ and DISC, and our case study examples show that differences appear in both theoretical foundations, and research approaches and applications. Nevertheless, we argue that studying quality and safety processes in hospitals requires general aspects such as diagnosis, multiple methods, and longitudinal fieldwork and data collection activities to understand organizational and contextual aspects emphasized in both models. The findings might indicate that the choice of model is of less importance, and that the aspects of organizational structure and complexity, leadership, culture, power, mindfulness, and learning represent the core of studying quality and safety.

Original languageEnglish
Title of host publication11th International Probabilistic Safety Assessment and Management Conference and the Annual European Safety and Reliability Conference 2012, PSAM11 ESREL 2012
Pages5954-5965
Number of pages12
Publication statusPublished - 2012
Externally publishedYes
EventInternational Probabilistic Safety Assessment and Management Conference and the Annual European Safety and Reliability Conference 2012, PSAM11 ESREL 2012 - Helsinki, Finland
Duration: 25 Jun 201229 Jun 2012
Conference number: 11th

Conference

ConferenceInternational Probabilistic Safety Assessment and Management Conference and the Annual European Safety and Reliability Conference 2012, PSAM11 ESREL 2012
Country/TerritoryFinland
CityHelsinki
Period25/06/1229/06/12

Keywords

  • Patient safety
  • Quality improvement
  • Theoretical models

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