High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement

Taylor, Natalie; Clay-Williams, Robyn; Hogden, Emily; Braithwaite, Jeffrey; Groene, Oliver

doi:10.1186/s12913-015-0879-z

Table 4 Methods used to identify factors associated with high performance

From: High performing hospitals: a qualitative systematic review of associated factors and practical strategies for improvement

Study	Data collection	Participant numbers and sampling method	Participant professions (N)
Bradley et al. (2006) [10]	Interviews	Interviews	Interviews
	- Open-ended interviews conducted with individuals and groups, lasting 1–1.5 h	- Total participants: 122	- Physicians (23), Nurses (37), Administrators (44), Quality management staff (8), Clinical/support staff (10)
		- Participants per site: approximately 10-12
		- Participants at HP sites: 122
		- Sampling: Nonprobability
Mannion et al. (2005) [44]	Interview	Interviews	Interviews
	- Semi-structured	- Total participants: Approximately 60^a	- Chief Executive and Medical Director
	Document review	- Participants per site: 8-11
	- Commission for Health Improvement report and internal documents	- Participants at HP sites: 40^a
	Site Visits	- Sampling: NS
Sautter et al. (2007) [37]	Interviews	Interviews	Interviews
	- 1.5 h	- Total participants, Participants per site and Participants at HP sites: NS	- Senior hospital leadership, chief cardiologist and Medical chief of staff
	- Semi-structured	- Sampling: Nonprobability	- Physician (6), Nurse (26), Administration (21), Clinical staff (4)
	- Semi-structured	- Total participants: 57
	- Conducted with individuals and groups	- Participants per site: NS
		- Participants at HP sites: 38^a
		- Sampling: Nonprobability
Cherlin et al. (2013) [112]	Interviews	Interviews	Interviews
	- Standard discussion guide used for 1 h interview
	Site visits
	- 1-2 day visits to review previous years’ activities.
Landman et al. (2013) [32]	Interviews	Interviews	Interviews
	- Standard interview guide used	- Total participants: 85	- Physician (n = 17), Nurse (n = 29), Administration (n = 32), Clinical staff (n = 7)
	Site visits	- Participants per site: NS
	- Emergency Medical Services medical director during EMS training session (1 site).	- Participants at HP sites: 46^a
		- Sampling: Nonprobability
Rangachari (2008) [31]	Interview	Interviews	Interviews
	- Semi-structured interview conducted with individuals and groups, lasting 0.75-1 h	- Total participants: Approximately 24^a	- Hospital administrators^a, Physician leaders^a, Coding managers^a
	Survey
	- Online survey on knowledge exchange related to quality measurement	- Participants per site: Approximately 6^a
		- Participants at HP sites: Approximately 12^a
		- Sampling method: NS
		Survey
		- Total participants: 65
		- Participants per site: NS
		- Participants at HP sites: 45
		- Sampling: Nonprobability
Baumann et al. (2007) [47]	Interviews	Interviews	Interviews
	- Topic guide	- Total participants: 42	- Directors of nursing, Service managers, Social services team managers, Lead hospital discharge coordinators, Care managers, Discharge facilitators
		- Participants per site: (hospitals/acute trusts) 14^a
		- Participants at HP sites: 14^a
		- Sampling: Nonprobability
Rose et al. (2012) [45]	Interviews	Interviews	Interviews
	- Semi-structured (lasting 0.3-1 h)	- Total participants: 56	- Direct-care ACC staff (25), ACC support staff (6), Pharmacy administration (11), Physicians (6), Other staff (7), Supervisor of clerks (1)
	Observations	- Participants per site: NS
	- Approximately 4 h of clinical care.	- Participants at HP sites: 31^a
	Documents	- Sampling: Nonprobability
	- ACC-related documents	- Sampling: Nonprobability
Keroack et al. (2007) [34]	Documents	Interviews	Interviews
	- Internal documents	- Total participants: NS	- CEO, Governing board members, Chief medical officer, Chief nursing officer, Chief financial officer, Clinical department chairs, Division chiefs, Nursing unit directors, Medical unit directors, Residents, Medical and nursing staff
	Site visits	- Participants per site: “dozens”
	- Document verification and information gathering (interviews) during 1.5 days	- Participants at HP sites: NS
	Interviews	- Sampling: NS
	- Open ended questions	- Sampling: NS
Hockey and Bates (2010) [42]	Interviews	Interviews	Interviews
	- Semi-structured, 0.75-1 h interview	- Total participants: 17	- Senior residents (2), Senior internists (3), Cardiologist (1), Pulmonologist (1), Nephrologist (1), Hospitalists (4), General internists (5)
		- Participants per site: NS
		- Participants at HP sites: NS
		- Sampling: Nonprobability
Adelman (2012) [41]	Document review	Interviews	Interviews
	- MBNQA/Baldrige award application.	- Total participants: 20	- CEO, Baldrige lead for the hospital, Clinical services area director, Frontline manager/clinical services area supervisor, Frontline nurse.
	Interviews	- Participants per site: 5
	- Semi-structured	- Participants at HP sites: 20
	- Semi-structured	- Sampling: NS
VanDeusen Lukas et al. (2010) [36]	Interviews	Interviews	Interviews
	- Semi-structured	- Total participants: 137^a	- Director, Chief of staff, Nurse executive, Associate director, Clinical redesign team members, Clinical redesign team leaders, Project improvement advisor, Front-line staff
		- Participants per site: NS
		- Participants at HP sites: 71^a
		- Sampling: NS
Kramer et al. (2008) [40]	Interviews (three types)	Interviews	Interviews
	- 2-h, group orientation interviews	- Total participants: 906^a	- Nurse manager, Director group, Staff nurses, Nurse managers, Physicians, Chief nursing officer, Chief operating officer, Departmental representatives
	- Individual interviews	- Participants per site: NS
	- Semi-structured expert interviews	- Participants at HP sites: 906^a
	Observations	- Sampling: NS/Nonprobability
	- 26 council meetings and lunch meetings (6 hospitals)
	Operational and evaluation data
	- Internal documents and CWEQII tool
Parsons and Cornett (2011) [35]	Interviews	Interviews	Interviews
	- 1 h	- Total participants: 15	- Chief Nurse Officers (15)
		- Participants per site: 1^a
		- Participants at HP sites: 15
		- Sampling: Nonprobability
Curry et al. (2011) [38]	Interviews	Interviews	Interviews
	- 1 h	- Total participants: 158	- Physicians (19), Nurses (52), Administration (65), Clinical staff (22)
	- Standard discussion guide used	- Participants per site: 14 (average)
	Site visits	- Participants at HP sites: 109^a
	- Debriefing sessions (organizational psychologist and site visit teams)	- Sampling: NS
Puoane et al. (2008) [33]	Observations	Interviews	Interviews
	- Structured approach to observing ward procedures during 3 days per hospital	- Total participants: 32^a	- Matrons, Hospital superintendent, Doctors, Sister-in-charge or her deputy, Professional and enrolled nurses
	Interviews	- Participants per site: 8^a	Focus groups
	- Semi-structured interviews (0.75-1 h)	- Participants at HP sites: 16^a	- Nurses (various categories)
	Focus groups	- Sampling method: NS
	Quantitative measures	Focus groups
	- Hospital environment data	- Approx 8 participants per focus group^a
	- Hospital environment data	- Recruitment: NS
Stanger et al. (2012) [43]	Interviews	Interviews	Interviews
	- 1 h	- Total participants: NS (7 interviews)	- Transfusion laboratory managers
	- Open-ended	- Participants per site: NS
		- Participants at HP sites: NS (7 interviews)
		- Sampling: Nonprobability
Kane et al. (2009) [109]	Interviews	Interviews	Interviews
	- 0.75-2 h	- Total participants: NS (73 interviews)	Board members and CEOs
	- Semi-structured	- Participants per site: 5–7 (unclear)
		- Participants at HP sites: NS (44 interviews)
		- Sampling: Nonprobability
Olson et al. (2011) [48]	Interviews	Interviews	Interviews
	- Semi-structured	- Total participants: 13	- Stroke coordinator, Stroke manager, Neurologist, Radiologist, ED nurse manager, Nurse manager, Pharmacist, Physician
		- Participants per site: 1-4
		- Participants at HP sites: 13
		- Sampling: Nonprobability

HP = high performing
NS = information not stated in paper
^aClarification sought and provided by corresponding author via email

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ISSN: 1472-6963

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