Strategies for Quality Improvement and Increased Efficiency in Health Care Systems

Mattias Elg
Division of Quality Management and Technology/HELIX research centre, Linköping Institute of Technology, Sweden

Jesper Olsson
Medical Management Centre, Karolinska Insitutet, Sweden

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Ingår i: 11th QMOD Conference. Quality Management and Organizational Development Attaining Sustainability From Organizational Excellence to SustainAble Excellence; 20-22 August; 2008 in Helsingborg; Sweden

Linköping Electronic Conference Proceedings 33:40, s. 471-480

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Publicerad: 2008-12-09


ISSN: 1650-3686 (tryckt), 1650-3740 (online)


Purpose: The purpose of the present study is to develop practical knowledge about the management of strategic improvement and increased effectiveness in health care systems.

Design/methodology/approach: In the study; we use an interactive research design. This means that researchers and practitioners collaborate on the various issues of the research project (problem analysis; discussions of empirical material; analysis and writing). Four main sub-projects concentrating on studying management and improvement of health care systems has been used in order to compile the findings.

Findings: In the study; we develop nine questions that are essential. These questions embrace important aspects that organizations should work with in order to succeed with improvement initiatives: These are: 1. How do we create awareness of the need for change? 2. What results do we expect from the improvement work? 3. What resources do we need in order to succeed in the improvement work? 4. How and where do we start the improvement work? 5. How do we work with the logistics of health care from a patient perspective? 6. How can we increase our organizational learning? 7. How do we create long-term thinking and commitment? 8. How do we design IT systems which support new and better work procedures? 9. What do we need to cease doing in our work?


Strategy; Quality Improvement; Transformation; Health Care System


Bar-Yam; Y. (1997). Dynamics of Complex Systems. Reading Massachusetts; Perseus Books

Bar-Yam; Y. (2006). ”Improving the Effectiveness of Health Care and Public Health: A Multiscale Complex Systems Analysis.” American Journal of Public Health 96(3): 459-466

Batalden P; Davidoff F: Whats is “quality improvement” and how can it transform healthcare? Qual. and Saf. Health Care 2007;16:2-3

Beer; M.; & Nohria M.; (2000) Breaking the Code of Change; Harvard Business School Press

Berwick; D. M. (1996). «A Primer on Leading the Improvement of Systems.» British Medical Journal 312(7031): 619-622

Cederqvist; J. and E. Hjortendal-Hellman (Ds 2005:7). Iakttagelser om landsting. Finansdepartementet

Collier; J. United States Indian Administration as a Laboratory of Ethnic Relations; Social Research; 12; 275-276.

Collins; J. C.; and Collins J. (2001) Good to Great: Why Some Companies Make the Leap...and Others Don’t; Harper Business

Deming; E. (1986). Out of the crisis. Boston; Massachusetts Institute of Technology

Greenhalgh; T.; R. Glenn; et al. (2004). ”Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations.” The Milbank Quarterly 82(4): 581-629

Horbrook; M.; Hurtardo; A.; & Johnson; R. (1985). Health care episodes: definition; measurement and use. Medical care review; 42 (2); 163-218

Kazandijan; V. A.; & Lied; T. (1999). Healthcare Performance Measurement: Systems Design and Evaluation. Milwaukee: ASQ

Lewin; K. (1946) Action Research and Minority Problems; Journal of Social Issues; 2(4); 34-46.

Lindmark; J.; & Elg; M. (2005). Den medicinska beslutsprocessen som grund för beskrivning och analys av hälso- och sjukvård - Flödesmodellen som verktyg. Stockholm: Sveriges Kommuner och Landsting

NATIONAL STRATEGI for kvalitetsudvikling i sundhedsvæsenet. Danmark (2002)

Nielsen; K.A.; & Svensson ; L.; (2006) Action and Interactive Research Beyond Practice and Research. Maastricht: Shaker Publishing.

Nolan; T. and M. Schall (1996). Reducing Delays and Waiting Times Throughout the Healthcare System. Boston; MA; Institute for Healthcare Improvement

OECD (2004). Towards high-performing health systems. T. O. H. Project

Olsson; J. (2002). Factors of Importance for Understanding Successful Improvement Initiatives in Swedish Health Care. Chalmers University of Technology; Göteborg
Olsson; J.; Kammerlind; P.; Thor; J.; & Elg; M. (2003). Surveying Improvement Activities in Health

Care on a National Level - The Swedish Internal Collaborative Strategy and its Challenges. Quality Management in Health Care; 12(4); 202-216

Sachs; M. A. (2004). Fokusrapport Kvalitetskostnader. S. l. landsting

Sorian; R. (2006). Measuring; Reporting; and Rewarding Performance in Healthcare. Comission on a high performance health system; The Commonwealthfound

Strategier för effektivisering (2007) Sveriges Kommuner och Landsting

Universitetssamverkan för Förbättringskunskap; Sveriges Kommuner och Landsting; www.skl.se/usf

Transformera System – från öar till helhet. Sveriges Kommuner och Landsting; www.skl.se

Van de Ven; A.; Scott Poole; M. &Angle; H. (2000) Research on the management of innovations; Oxford University Press

Øvretveit; J. (2006). Ledarens roll i kvalitetsförbättrings och säkerhetsarbetet; Sveriges Kommuner och Landsting.

tp://www.skl.se/artikel.asp?A=17111&C=1150&ArticleVersion ...og bedre skal det bli! Norska strategin for kvalitetsforbedring i sosial – og helsetjenesten

tp://shdir.no/publikasjoner/veiledere/nasjonal_strategi_for_kvalitetsforbedring_i_sosial__og_ helsetjenesten__og_bedre_skal_det_bli___2005_2015__2913__123 0.

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