The role of hospital managers in quality and patient safety: a systematic review. Issue 9 (5th September 2014)

• Record Type: Journal Article
• Authors: Parand, Anam; Dopson, Sue; Renz, Anna; Vincent, Charles
• Is Part Of: BMJ open. Volume 4:Issue 9(2014)
• Publication Date: 2014-09-05
• Subjects: HEALTH SERVICES ADMINISTRATION & MANAGEMENT -- Systematic literature review -- Patient Safety -- Leadership; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2014-005055
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To review the empirical literature to identify the activities, time spent and engagement of hospital managers in quality of care. Design: A systematic review of the literature. Methods: A search was carried out on the databases MEDLINE, PSYCHINFO, EMBASE, HMIC. The search strategy covered three facets: management, quality of care and the hospital setting comprising medical subject headings and key terms. Reviewers screened 15 447 titles/abstracts and 423 full texts were checked against inclusion criteria. Data extraction and quality assessment were performed on 19 included articles. Results: The majority of studies were set in the USA and investigated Board/senior level management. The most common research designs were interviews and surveys on the perceptions of managerial quality and safety practices. Managerial activities comprised strategy, culture and data-centred activities, such as driving improvement culture and promotion of quality, strategy/goal setting and providing feedback. Significant positive associations with quality included compensation attached to quality, using quality improvement measures and having a Board quality committee. However, there is an inconsistency and inadequate employment of these conditions and actions across the sample hospitals. Conclusions: There is some evidence that managers' time spent and work can influence quality and safety clinical outcomes, processes and performance. However, there is a dearth of empirical studies, further weakened by a lack of objective outcome measures and little examination of actual actions undertaken. We present a model to summarise the conditions and activities that affect quality performance.