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Knowledge management infrastructure to support quality improvement: A qualitative study of maternity services in four European hospitals
Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.ORCID iD: 0000-0003-4853-314
IVL Swedish Environmental research Institute, Sweden.
SHARE – Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway.
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London.
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2019 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054Article in journal (Refereed) Epub ahead of print
Abstract [en]

The influence of multilevel healthcare system interactions on clinical quality improvement (QI) is still largely unexplored. Through the lens of knowledge management (KM) theory, this study explores how hospital managers can enhance the conditions for clinical QI given the specific multilevel and professional interactions in various healthcare systems.

The research used an in-depth multilevel analysis in maternity departments in four purposively sampled European hospitals (Portugal, England, Norway and Sweden). The study combines analysis of macro-level policy documents and regulations with semi-structured interviews (96) and non-participant observations (193 hours) of hospital and clinical managers and clinical staff in maternity departments.

There are four main conclusions: First, the unique multilevel configuration of national healthcare policy, hospital management and clinical professionals influence the development of clinical QI efforts. Second, these different configurations provide various and often insufficient support and guidance which affect professionals’ action strategies in QI efforts. Third, hospital managers’ opportunities and capabilities for developing a consistent KM infrastructure with reinforcing enabling conditions which merge national policies and guidelines with clinical reality is crucial for clinical QI. Fourth, understanding these interrelationships provides an opportunity for improvement of the KM infrastructure for hospital managers through tailored interventions.

Place, publisher, year, edition, pages
Elsevier, 2019.
Keywords [en]
Multilevel interaction, Healthcare management, Hospital management, Professionals’ action strategies, Knowledge management, Improvement science
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-47326DOI: 10.1016/j.healthpol.2019.11.005Scopus ID: 2-s2.0-85077715250Local ID: ;HHJIMPROVEIS,JTHLogistikISOAI: oai:DiVA.org:hj-47326DiVA, id: diva2:1384807
Funder
EU, FP7, Seventh Framework Programme, 241724Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-01-29

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Karltun, AnetteAndersson-Gäre, Boel

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JTH, Supply Chain and Operations ManagementThe Jönköping Academy for Improvement of Health and WelfareHHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare)
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Health Policy
Health Care Service and Management, Health Policy and Services and Health Economy

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