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Sustaining improvement? The 20-year Jönköping Quality Improvement program revisited
University Lyon III, France and Fédération des hôpitaux vaudois, Prilly, Switzerland.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare. Karolinska Institutet.ORCID iD: 0000-0003-1814-4478
National Nursing Research Unit, King’s College, London, United Kingdom.
2015 (English)In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 24, no 1, 21-37 p.Article in journal (Refereed) Published
Abstract [en]

Background: There is scarce evidence of organization-wide and sustained impact of quality improvement (QI) programsin health care. For 20 years, the Jönköping County Council’s (Sweden) ambitious program has attracted attention from practitioners and researchers alike. Methods: This is a follow-up case of a 2006 study of Jönköping’s improvement program, triangulating data from 20 semi-structured interviews, observation and secondary analysis of internal performance data. Results: In 2010, clinical outcomes had clearly improved in 2 departments (pediatrics, intensive care), while process improvements were evident in many departments. In an overall index of the 20 Swedish county councils’ performance, Jönköping had improved its ranking since 2006 to lead in 2010. Five key issues shaped Jönköping’s improvement program since 2006: a rigorously managed succession of chief executive officer; adept management of a changing external context; clear strategic direction relating to integration; a broadened conceptualization of “quality” (incorporating clinical effectiveness, patient safety, and patient experience); and continuing investment in QI education and research. Physician involvement in formal QI initiatives had increased since 2006 but remained a challenge in 2010. A new clinical information system was being deployed but had not yet met expectations. Conclusions: This study suggests that ambitious approaches can carry health care organizations beyond the sustainability threshold.

Place, publisher, year, edition, pages
2015. Vol. 24, no 1, 21-37 p.
Keyword [en]
case study, CEO succession, culture, health services management, leadership, outcome and process assessment (health care), patient safety, quality improvement, sustainability, total quality management
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-25364DOI: 10.1097/QMH.0000000000000048ISI: 000350744100005PubMedID: 25539488Scopus ID: 2-s2.0-84920716198Local ID: HHJKvalitetISOAI: oai:DiVA.org:hj-25364DiVA: diva2:773106
Available from: 2014-12-18 Created: 2014-12-18 Last updated: 2016-03-24Bibliographically approved

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Citation style
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