Balding and Leggat 2020 Making high quality care an organisational strategy
Longitudinal mixed-methods study (2015–2017) of a strategic quality management system (SQMS) implemented in four experimental and four control Australian hospitals (one experimental later removed). The SQMS emphasized Juran’s Quality Trilogy planning component: defining high-quality care, translating goals to point-of-care actions, strengthening clinical governance, and monitoring goal achievement. Data: 166 focus groups (~900 participants), validated instruments (IHI self-assessment, QMCI, CQII, QSMS), and eight routinely reported quality indicators (five analysed: hand hygiene non-compliance, medication incidents, patient falls, pressure incidents, SAB). Findings: partial implementation across three analysed SQMS hospitals; improved staff engagement and shared definition of quality in SQMS hospitals; statistically lower hand hygiene non-compliance in SQMS vs control (p=.048); other indicators showed no significant between-group differences. Implementation challenges included leadership turnover, competing priorities, and incomplete adherence to change-management steps; three-year timeframe likely insufficient to observe full effects.
Questions this document answers
2015 to 2017
Eight hospitals volunteered; four experimental (initially) and four control; one experimental hospital was later removed from the results.
Hand hygiene non-compliance (HH), medication incidents (MI), patient falls (Falls), pressure incidents (PI), and staphylococcal bacteraemia (SAB).
Hand hygiene non-compliance was lower in the experimental (SQMS) group compared with control (p = .048).