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Quality improvement in health care organizations: A general systems perspective
Author(s) -
Yank Glenn
Publication year - 1995
Publication title -
behavioral science
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.371
H-Index - 45
eISSN - 1099-1743
pISSN - 0005-7940
DOI - 10.1002/bs.3830400202
Subject(s) - quality (philosophy) , quality management , autonomy , health care , total quality management , business , quality policy , dysfunctional family , process management , organizational performance , government (linguistics) , knowledge management , control (management) , public relations , psychology , political science , marketing , computer science , philosophy , linguistics , epistemology , artificial intelligence , law , psychotherapist , service (business)
A systems analysis of healthcare organizations demonstrates that methods for improving quality involve the effective feedback regulation of key organizational performance parameters. Information flow is impaired in dysfunctional healthcare organizations, which often disregard significant clinical problems while preferentially tracking nonclinical indicators and clinical data considered most likely to meet the organization's standards. Such organizations thus achieve "pseudocompliance" with external requirements, but do not systematically work to improve the quality of clinical care or their performance as organizations. Efforts by government agencies and national organizations to foster quality improvement activities have had limited success precisely because local organizations perceive these efforts as externally imposed. Leaders' anxieties about their own and their organizations' autonomy, control, and performance can cause unwillingness to review data indicating performance problems, oversimplification of decision criteria, and reluctance to formulate meaningful conclusions and act on them. Contemporary quality improvement models, such as Continuous Quality Improvement (CQI) and Total Quality Management (TQM), reconnect leaders to their organizations' quality processes by emphasizing the leaders' roles in promoting quality as an organizational value, setting meaningful quality goals, and actively u sing information to improve organizational effectiveness.