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Quality Management in Health Care: A Literature Review
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, The Institute of Technology.
Linköping University, Department of Management and Engineering, Quality Technology and Management. Linköping University, HELIX Vinn Excellence Centre. Linköping University, The Institute of Technology.ORCID iD: 0000-0002-9155-189X
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Purpose – The purpose of this article is to provide input to the discussion of quality management (QM) research in health care through a problematization of its defining characteristics, and to identify historical and contemporary trends regarding QM in the scientific discourse on health care.

Design/methodology/approach – This article is based on a literature review of leading journal articles concerning quality management in health care. Articles have been selected based on citation in Scopus and ISI/Web of Science, with a total of 36 articles.

Findings – The review has shown that there are two logics to quality management and improvement work in health care. Dominating the field is an ambition to standardize the provision of health care through an evidence based approach. The other approach is based on a system based logic, aiming to enforce organizational competence and system wide improvement. Unlike the general discourse on quality management is the customer perspective is rather weakly represented in the reviewed literature.

Research limitations/implications – This article provides some insights that may contribute to a better understanding of the conditions for doing research and improvement in health care.

Originality/value – The article provides an overview of the defining characteristics of Quality Management in health care, along with a historical perspective on the theoretical development of Quality related topics in health care research. This provides important input to management researchers entering the health care field. To the authors’ knowledge, this is the first review on this topic.

Keyword [en]
Quality management, health care, core principles
National Category
Engineering and Technology
URN: urn:nbn:se:liu:diva-78714OAI: diva2:535087
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2015-02-05Bibliographically approved
In thesis
1. Co-creation in Healthcare Service Development: A Diary-based approach
Open this publication in new window or tab >>Co-creation in Healthcare Service Development: A Diary-based approach
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The patient is the only person who experiences the complete course of a healthcare problem, from first symptom to any contacts with the healthcare system to examination, treatment, follow-up activities and rehabilitation. The aim of this thesis is to explore how caregivers, together with patients, can draw on the knowledge patients acquire from their experiences in healthcare service development. This represents a break with the traditional role of the patient, which has been one of a passive receiver of care, following a supplier-centered view on value creation, which has increasingly been challenged both in the healthcare management discourse and in service research. Instead it is argued that value can only be co-created with customers, or patients in the case of healthcare. This means that the patients’ value-creating processes and contexts need to be emphasized and that patients are seen as a possible resource in their own care but also in the development of services and products. Despite this change in discourse, practical methods and empirical studies concerning patient involvement are scarce. This thesis adds to the field through an empirical exploration of co-creation in the development of healthcare. Through an action research approach, researchers and healthcare personnel have collaborated to develop a model for involving patients in service development, by inviting patients to share ideas and experiences through diaries.

A workable, three-phase (preparation, execution and learning) model for patient involvement through diaries has been developed, and applied in three clinics (orthopedic, rehabilitation, gastro). A total of 53 patients from the different care processes have contributed ideas and experiences using paper and pen diaries or blogs, or by calling an answering machine. By doing so for a period of 14 days, the patients have submitted a total of 360 ideas.

Three ways are proposed for utilizing the rich data submitted by the patients in service development. First, ideas from diaries can be used as input for service development. Second, a larger sample of diaries can be used to create a report of patient experiences, in which problem areas in the care process can be identified, and combined with other statistics. Third, individual patients’ stories can be highlighted and serve as a basis for discussion in the organization to shift the focus to the patient’s experience, serving as a motivator for change within the caregiving organization.

The study shows that patients can share ideas and experiences regarding a range of topics, including clinical, organizational, social, informational, and practical issues and attitudes among healthcare staff. The contexts to which these ideas and experiences applied were caregiver, home, extended caregiver, and work, and often concerned topics and aspects of the patient’s care process that are invisible to the caregiver.

Although healthcare organizations should be aware of the limitations to participation an illness may imply among some patients, patient co-creation in service development provides several important benefits. Acquiring knowledge regarding the parts of the patient’s care process that are invisible to the caregiver is key to improving care and supporting patients’ work of healing and managing life. Patients’ insights and creativity are an untapped resource for development of many aspects of the healthcare process.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2012. 54 p.
Linköping Studies in Science and Technology. Thesis, ISSN 0280-7971 ; 1539
National Category
Engineering and Technology
urn:nbn:se:liu:diva-78717 (URN)LiU-TEK-LIC 2012:24 (Local ID)978-91-7519-864-4 (ISBN)LiU-TEK-LIC 2012:24 (Archive number)LiU-TEK-LIC 2012:24 (OAI)
2012-06-12, ACAS, A-huset, Campus Valla, Linköpings universitet, Linköping, 13:15 (Swedish)
Available from: 2012-06-19 Created: 2012-06-19 Last updated: 2012-06-19Bibliographically approved

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Engström, JonLangstrand, Jostein
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