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Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies

Overview of attention for article published in BMJ Quality & Safety, July 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#17 of 1,247)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

news
1 news outlet
twitter
444 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
1 Dimensions

Readers on

mendeley
40 Mendeley
Title
Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies
Published in
BMJ Quality & Safety, July 2018
DOI 10.1136/bmjqs-2017-007573
Pubmed ID
Authors

Valerie M Vaughn, Sanjay Saint, Sarah L Krein, Jane H Forman, Jennifer Meddings, Jessica Ameling, Suzanne Winter, Whitney Townsend, Vineet Chopra

Abstract

Identifying characteristics associated with struggling healthcare organisations may help inform improvement. Thus, we systematically reviewed the literature to: (1) Identify organisational factors associated with struggling healthcare organisations and (2) Summarise these factors into actionable domains. Systematic review of qualitative studies that evaluated organisational characteristics of healthcare organisations that were struggling as defined by below-average patient outcomes (eg, mortality) or quality of care metrics (eg, Patient Safety Indicators). Searches were conducted in MEDLINE (via Ovid), EMBASE, Cochrane Library, CINAHL, and Web of Science from database inception through February 8 2018. Qualitative data were analysed using framework-based synthesis and summarised into key domains. Study quality was evaluated using the Critical Appraisal Skills Program tool. Thirty studies (33 articles) from multiple countries and settings (eg, acute care, outpatient) with a diverse range of interviewees (eg, nurses, leadership, staff) were included in the final analysis. Five domains characterised struggling healthcare organisations: poor organisational culture (limited ownership, not collaborative, hierarchical, with disconnected leadership), inadequate infrastructure (limited quality improvement, staffing, information technology or resources), lack of a cohesive mission (mission conflicts with other missions, is externally motivated, poorly defined or promotes mediocrity), system shocks (ie, events such as leadership turnover, new electronic health record system or organisational scandals that detract from daily operations), and dysfunctional external relations with other hospitals, stakeholders, or governing bodies. Struggling healthcare organisations share characteristics that may affect their ability to provide optimal care. Understanding and identifying these characteristics may provide a first step to helping low performers address organisational challenges to improvement. PROSPERO: CRD42017067367.

Twitter Demographics

The data shown below were collected from the profiles of 444 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 40 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 23%
Student > Ph. D. Student 5 13%
Unspecified 4 10%
Other 4 10%
Student > Master 4 10%
Other 14 35%
Readers by discipline Count As %
Medicine and Dentistry 13 33%
Nursing and Health Professions 11 28%
Unspecified 6 15%
Business, Management and Accounting 3 8%
Social Sciences 3 8%
Other 4 10%

Attention Score in Context

This research output has an Altmetric Attention Score of 318. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 January 2019.
All research outputs
#31,410
of 12,366,144 outputs
Outputs from BMJ Quality & Safety
#17
of 1,247 outputs
Outputs of similar age
#1,574
of 269,807 outputs
Outputs of similar age from BMJ Quality & Safety
#2
of 18 outputs
Altmetric has tracked 12,366,144 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,247 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 34.0. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,807 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 18 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.