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Quality and Safety in European Union Hospitals

A Research-based Guide for Implementing Best Practice and a Framework for Assessing Performance (QUASER)


Funded by the EU Seventh Framework Programme (FP7). April 2010 - June 2013.

Contact Dr Susie Edwards: susie.edwards@ucl.ac.uk

This three-year study will explore the relationships between the organisational and cultural characteristics of hospitals, and how these impact upon clinical effectiveness,  patient safety and patient experience in European Union countries. Co-ordinated by the Department of Applied Health Research, UCL, partners include the Imperial Centre for Patient Safety and Service Quality (CPSSQ); the Department of Health Studies at the University of Stavanger, Norway; the Department of Health Policy & Management, Erasmus University, Netherlands; Qulturum, Jönköping County Council, Sweden; ISCTE – Instituto Universitario de Lisboa, Lisbon, Portugal; King's College London, UK.

The key objectives of the project are to identify organisational and cultural characteristics linked to the effectiveness, safety and patient experience of hospital care, and the quantitative and qualitative indicators of this. Data will be collected in 10 hospitals in the five partner countries (two in each of the five partner countries), with additional studies of two clinical microsystems in five of these (one in each of the partner countries).

Whilst there is a good understanding of the types of quality improvement undertaken in healthcare, less is known of the organisational and cultural processes that determine the effectiveness of these methods. By examining the relationship between these processes and quality from macro (national healthcare system) down through the meso (hospital) to micro (frontline clinical team) levels in each of the five partner countries, the study will unveil how the dynamics and interactions between these different levels impact on sustained quality of hospital care.

This research will enable the team to deliver effective products to hospital leaders, based on the realities of implementing quality improvement programmes, and findings will be used to design and disseminate an evidence-based Quality and Safety Guide for Hospitals. This will be a 'best practice' framework to guide hospitals on implementing effective organisation-wide quality and safety improvement initiatives. A Framework for Assessing Hospital Quality will also be compiled, enabling purchasers of hospital services and governments throughout the EU to monitor and assess the effectiveness, safety and patient experience of hospital care.

Project contact details:-

  • Department of Applied Health Research, UCL (Coordinator) - Professor Naomi Fulop, n.fulop@ucl.ac.uk

Publications:-

Prospects for comparing European hospitals in terms of quality and safety: lessons from a comparative study in five countries. Susan Burnett; Anna Renz; Siri Wiig; Alexandra Fernandes; Anne Marie Weggelaar; Johan Calltorp; Janet E. Anderson; Glenn Robert; Charles Vincent; Naomi Fulop. International Journal for Quality in Health Care 2013; doi: 10.1093/intqhc/mzs079

Robert, G. Anderson, J. Burnett, S. Aase, K. Andersson-Gare, B. Bal, R. Caltorp, J. Nunes, F. Weggelaar, AM. Vincent, C. Fulop, N. (2011) A longitudinal, multi-level comparative study of quality and safety in European hospitals: the QUASER study protocol. BMC Health Services Research 2011, 11:285. PubMed

Conference presentations:-

Fulop, N. (2011). The road less travelled: The story of an FP7 project – Studying Quality and Safety in European Hospitals (QUASER). Presented at the Service Delivery and Organisation (SDO) Network and Health Services Research (HSR) Network’s fourth joint annual conference, held 7-8 June in Liverpool, UK.

Fulop, N. (2012). Organisational and social perspectives on patient safety and quality in healthcare: Contributions, critiques, and future directions. Keynote address, 2nd Nordic Conference on Research in Patient Safety and Quality in Healthcare. Held 6-7 March, 2012, Copenhagen.

Fulop, N. (2012). Studying quality and safety in European hospitals – QUASER: Understanding organisational and cultural factors influencing the implementation of QI systems. Presented at International Forum on Quality and Safety In Healthcare, Paris, 19 April, 2012.

Gomes, S. (2011). The QUASER project. Poster presented at the First International Meeting on Quality and Patient Safety held 27-28 May, in Lisbon, Portugal.

Gomes, S., Fernandes, A., Martins, L., & Nunes, F. (2011). Quality management in hospitals: Logic of adoption and implementation of QI programmes. Presented at the Fórum Excelência, held 27th-29th June, Lisbon, Portugal.

Gomes, S., Fernandes, A., Martins, L., & Nunes, F. (2011). QUASER Project: Quality and Safety in European Union Hospitals. Presented at the Fórum Excelência, held 27-29 June in Lisbon, Portugal.

Robert, G. (2012). Creating high performing health care organizations. Panel session. Canadian Association for Health Services and Policy Research Annual Meeting. To be held May 2012, Montreal, Quebec.

Weggelaar, A. (2011). Learn to improve, improved learning. Presented at the Academy of Management, Division of Health Care Management workshop, held 7 August, 2010 in Montreal, Canada.

Wiig, S., Aase, K., & the QUASER team (2012). A joyous occasion? How centralisation as part of quality improvement shapes power battles within organising of maternity care. Proceedings of the 2nd Nordic Conference on Research in Patient Safety and Quality in Healthcare. Held 6-7 March, 2012, Copenhagen.

Wiig, S., Aase, K., Pietikainen, E., Reiman, T., Macchi, L., Anderson, J., Robert, G.,& the QUASER team (2012). Studying quality and safety in hospitals by using different theoretical frameworks – what’s the difference? To appear in Proceedings of the joint conference of Probability Safety Assessment and Management and European Safety and Reliability (PSAM11 & ESREL) 2012. To be held 25-29 June, Helsinki, Finland.

Wiig, S., Harthug, S., von Plessen, C., & Burnett, S. (2011). Measuring quality and safety in Norwegian health care - time for a change? Presented at Healthcare Systems and Ergonomics and Patient Safety, June 22-24, Oviedo Spain. In Albolino, S., Bagnare, S., Bellandi, T., Llaneza, J., Rosal, G., & Tartaglia, R. (eds.) (2011). Healthcare Systems Ergonomics and Patient Safety 2011 – an alliance between professionals and citizens for patient safety and quality of life. CRC Press, Taylor& Francis Group, London, UK.

Wiig, S., Quartz, J., von Plessen, C., & Harthug, S. (2011). Organizing for quality and safety in health care - the Norwegian case. Presented at the European Safety and Reliability (ESREL) conference, 18th-22nd September 2011, Troyes, France. In Bérenguer, Grall & Guedes Soares (Eds). (2012). Advances in Safety, Reliability and Risk Management. Taylor & Francis Group, London.

Workshops:-

Groene, O., Fulop, N., & Sunol, R. (2012). Research into the effectiveness of European quality improvement systems: Approaches, evidence and current issues. BMJ Forum for Quality and Safety in Health Care, Paris, April, 2012.

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QUASER has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 241724.

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