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The purpose of this paper is to investigate the contextual factors contributing to the sustainability of healthcare quality improvement (QI) initiatives.

Themes from semi-structured interviews with international healthcare leaders are compared with Kaplan and Provost et al.’s (2012) model for understanding success in quality (MUSIQ). Critical success factors within these themes are shown in detail.

The interviews provide a rich source of information on critical success factors. The themes largely correspond with MUSIQ, reinforcing its robustness. An important factor emerging from the interviews was the importance of engagement with patients and families in QI, and this needs consideration in seeking to understand context in QI.

Interview participants represent a limited set of western countries and health systems. Their experiences may not hold true in other settings.

The detail on critical success factors provides QI practitioners with guidance on designing and implementing sustainable initiatives.

Including consideration of contextual factors for engagement with patients and families in frameworks for context in QI appears to be an original idea that will add value to such frameworks. Researchers in patient engagement are starting to address contextual factors and connections should be made with this work.

Care coordination for patients with chronic conditions is one aim of an integrated health care delivery system. The purpose of this paper is to compare findings from two separate New Zealand studies and discusses the implications of the results.

The paper describes and discusses the use of Patient Assessment of Chronic Illness Care Measure in two different geographic areas of New Zealand and at different times.

The studies suggest that, despite the time that has elapsed since government investment in care coordination for long-term conditions, there has been little change in the nature of service delivery from the patient perspective.

The paper highlights the shortcomings of simply providing additional funding for care coordination, without built in accountabilities, no planned evaluation and no concerted focus on what the model of care should look like.

This paper aims to describe a new process for creating points systems – i.e. decision criteria and their point values – for prioritising patients for access to elective health services.

The process was developed in New Zealand from a project the authors were closely involved in, beginning in 2004, to create new points systems, initially for coronary artery bypass graft (CABG) surgery and then successively for other elective services. The objective was to overcome the limitations of earlier methodologies for creating points systems.

The process, supported by internet‐based software, consists of seven steps performed by a working group of clinical leaders for the elective service concerned, in consultation with patient groups and other clinicians. The authors' experience reveals it is acceptable to clinicians and their professional organisations as well as to patient groups.

The process creates points systems that are valid and reproducible and based on a consensus of clinical judgements. The process is explained in a step‐by‐step manner so that it is possible for readers to apply it themselves to create points systems for their own patient‐prioritisation applications.