Impact and results of quality improvement and patient safety programmes in hospitals : HAS studies and projects
The last decade has seen an unprecedented rise in the development and implementation of quality and safety improvement initiatives in health care, both in France and abroad, as awareness of medical errors and variation in clinical practice and quality has grown. This has resulted in the introduction of improvement programmes nationwide, including hospital accreditation, professional practice appraisal, and accreditation of doctors in high-risk specialties.
However, given the significant public and professional investment in these health care quality and safety improvement initiatives, evaluation of these programs is essential.
HAS is currently involved in several actions aiming at assessing the impact of quality improvement systems to determine their effectiveness, the factors driving practice and organizational change, and where they should go next. This appears to be a necessary and crucial step to (re)design strategies that will engage the professionals, disseminate quality and safety culture and impact positively on the quality of care.
2014 : HAS at the heart of a European research project
HAS and the CCECQA (Comité de Coordination de l’Evaluation Clinique et de la Qualité en Aquitaine) were the coordinating bodies for hospital involvement and data collection in France for “Deepening our Understanding of Quality Improvement in Europe” (DUQuE), a major EU funded research project (November 2009 to August 2014). DUQuE aims to study the effectiveness of quality improvement systems and their impact on patient level outcomes. It explores whether the quality efforts in our hospitals and hospital departments are associated with better results in terms of clinical, patient safety and patient reported outcomes. Data collection was carried out using various methods in hospitals from 7 countries in Europe.
A supplement of the International Journal for Quality in Health Care containing twelve scientific papers and two editorials dedicated to the DUQuE project can be accessed directly
An appraisal guide providing an up-dated framework to assess quality and safety improvement in hospitals is available. It is based on state-of-the-art research and synthesises the results of the DUQuE project and other large-scale empirical studies, systematic reviews, and expert knowledge.
HAS is also publishing a number of reports on the impact of improvement initiatives in hospitals, including :
- A study on the impact of recommendations issued during accreditation procedures - 2013
- A survey carried out among 1200 health care professionals and 100 service user representatives on their perceptions of hospital accreditation -2013
- A literature review on the impact of accreditation of hospitals - 2010
Carried out by Matrix Insight.
- The IMGENI study - 2010
The IMGENI study carried out by the Centre for Organisational Sociology (CSO, Sciences Po) and Institute for training and research in organisations in healthcare and social sector (IFROSS) and coordinated by the Aquitaine Committee for Coordination of Clinical Assessment and Quality (CCECQA), on the implementation of the national quality indicator programme in the Aquitaine region.
- A literature review on public reporting of performance indicators - 2005
By Béatrice Fermon and Pierre Lévy (Laboratoire d’Economie et de Gestion des Organisations de Santé, Université Paris-Dauphine).