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Table 2 Proposed conceptual framework dimensions based on key elements of healthcare quality frameworks and value statements

From: Benchmarking outcomes on multiple contextual levels in lean healthcare: a systematic review, development of a conceptual framework, and a research agenda

 

Patients

Employed and affiliated staff

Costs

Service provision

Clinical outcome

Experience

Access

Processes

Continuous improvement

Strategic perspective

Quality frameworks

IHI Triple aim [32]

• Population health

• Experience of care

 

• Per capita cost

    

Quadruple aim [33]

• Population health

• Experience of care

• Wellbeing

• Per capita cost

    

IOM domains of healthcare quality [34]

• Safe

• Effective

• Patient-centered

 

• Efficient

• Timely

• Equitable

   

Balanced scorecard:

Perspectives [64]

• Customer value

• Customer satisfaction and/or retention

• Learning & growth

o human capital

o culture

• Financial

o financial performance

o effective resource use

 

• Internal process

o efficiency

o quality

 

• Learning & growth

o infrastructure & technology

o culture

The Malcolm Baldrige Criteria for Performance Excellence [65]

• Results:

o Product/Service

• Results:

o Customer Satisfaction

• Workforce focus

• Results: workforce

• Results: Financial and marketplace performance

 

• Results: operational effectiveness

• Measurement, analysis, and knowledge management

• Leadership

• Strategic planning

• Results: Leadership

• Customer Focus

OECD Health Care Quality Indicators Framework [66]

• Quality:

o Effectiveness

o Safety

• Quality:

o Responsiveness

o Patient Centeredness

 

• Cost/Expenditure

• Access

o Accessibility

   

Total Quality Management Principles [67]

 

• Customer Satisfaction

• Employee commitment

   

• Continuous Improvement

• Fact-Based Decision Making

• Effective Communications

• Strategic Thinking

• Integrated System

WHO Regional Office for Europe: Performance Assessment Tool for Quality Improvement in Hospitals (PATH) [68]

• Clinical effectiveness

• Safety

• Patient Centeredness

• Staff orientation

  

• Production efficiency

 

• Responsive Governance

Campbell et al.

Quality of Care Conceptual Framework [69]

• Effectiveness:

o Effectiveness of Clinical care

• Effectiveness:

o Effectiveness of inter-personal care

  

• Accessibility:

o Affordability

o Availability

   

A framework for High-Reliability Organizations in Healthcare [70]

 

• Engagement of patients and family

• Culture of safety

o Psychological safety

o Accountability

o Teamwork & communication

o Negotiation

   

• Learning system

o Continuous learning

o Improvement & measurement

o Reliability

o Transparency

• Effective leadership

Value statements

WHO: Goals of the Health System[71]

• Optimal health for all

• Responsiveness of care provision system

 

• Fair financing

    

Shingo guiding principles[36]

• Assure quality at the source

• Respect every individual

• Respect every individual

• Create constancy of purpose

  

• Focus on process

• Flow & pull value

• Seek Perfection

• Embrace Scientific thinking

• Lead with humility

• Think systemically

• Create value for the customer

Lean 4P Model[35]

• Philosophy (Create value, customer focus)

• People

  

• Process

• Problem solving

 

EFQM Excellence Model: Fundamental Concepts of Excellence[72]

• Adding Value for Customers

   

• Managing with agility

• Creating a sustainable future

• Developing organizational capability

• Harnessing creativity and innovation

• Leading with Vision, Inspiration and Integrity

  1. Abbreviations: EFQM the European Foundation for Quality Management; IHI Institute for Healthcare Improvement; IOM Institute of Medicine; OECD Organisation for Economic Co-operation and Development; WHO World Health Organization