Using quality measures for quality improvement: the perspective of hospital staff

• Published in: PloS one Vol. 9; no. 1; p. e86014
• Main Authors: Aghaei Hashjin, Asgar, Ravaghi, Hamid, Kringos, Dionne S, Ogbu, Uzor C, Fischer, Claudia, Azami, Saeid Reza, Klazinga, Niek S
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 23.01.2014; Public Library of Science (PLoS)
• Subjects: Accountability; Clinical medicine; Cost-Benefit Analysis; Cross-Sectional Studies; Data collection; Economics, Hospital; Feasibility studies; Health care policy; Health education; Health services; Hospitals; Hospitals - standards; Humans; Indicators; Information management; Information science; Measurement; Medical care quality; Medical personnel; Medical records; Medicine; Nursing; Patient care; Patients; Personnel, Hospital; Physicians; Population studies; Quality control; Quality Improvement; Quality Indicators, Health Care; Quality management; Success; Surveys; Surveys and Questionnaires; Total quality; Iran; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0086014

This study examines the perspectives of a range of key hospital staff on the use, importance, scientific background, availability of data, feasibility of data collection, cost benefit aspects and availability of professional personnel for measurement of quality indicators among Iranian hospitals. The study aims to facilitate the use of quality indicators to improve quality of care in hospitals. A cross-sectional study was conducted over the period 2009 to 2010. Staff at Iranian hospitals completed a self-administered questionnaire eliciting their views on organizational, clinical process, and outcome (clinical effectiveness, patient safety and patient centeredness) indicators. 93 hospital frontline staff including hospital/nursing managers, medical doctors, nurses, and quality improvement/medical records officers in 48 general and specialized hospitals in Iran. On average, only 69% of respondents reported using quality indicators in practice at their affiliated hospitals. Respondents varied significantly in their reported use of organizational, clinical process and outcome quality indicators. Overall, clinical process and effectiveness indicators were reported to be least used. The reported use of indicators corresponded with their perceived level of importance. Quality indicators were reported to be used among clinical staff significantly more than among managerial staff. In total, 74% of the respondents reported to use obligatory indicators, while this was 68% for voluntary indicators (p<0.05). There is a general awareness of the importance and usability of quality indicators among hospital staff in Iran, but their use is currently mostly directed towards external accountability purposes. To increase the formative use of quality indicators, creation of a common culture and feeling of shared ownership, alongside an increased uptake of clinical process and effectiveness indicators is needed to support internal quality improvement processes at hospital level.