To reduce healthcare quality variation, focus on the process
Variation in healthcare quality is an ongoing issue. This study seeks to understand how differences in hospital practices and policies can lead to disparities in consumer outcomes and overall care quality. The authors compared process and outcome measures to detect variation and characteristics of hospitals with lower variation.
Interestingly, the highest between-hospital variation was seen in process indicators. This suggests that hospitals have more control over and potential to improve processes than final clinical or consumer-reported outcomes.
The study makes several suggestions to reduce care quality variation:
Standardise Best Practice Processes
Hospitals should prioritise implementing evidence-based clinical guidelines and protocols. Regular updates to these guidelines based on the latest research and clinical evidence are crucial to maintaining their effectiveness.
Increase Data Transparency and Benchmarking
Transparent reporting of performance data allows hospitals to compare their outcomes with peer institutions. This involves publicly sharing quality indicators, such as infection rates, patient outcomes and readmission rates. Benchmarking against top-performing hospitals helps identify areas for improvement and encourages adopting best practices. Tools such as dashboards and scorecards can make it easier for hospitals to track progress and pinpoint specific areas needing attention.
Enhance Training and Education in EBP
Continuous professional development programs are essential to keep healthcare workers updated on the latest evidence-based practices. Simulation training and case studies can help staff practice and refine their skills. Creating a learning environment that encourages questioning and continuous improvement can help reduce discrepancies in care delivery.
Integrate reduction in variation with Quality Improvement Programs
Hospitals can achieve significant improvements by focusing on process indicators, where the most considerable variation and potential for change exist. These programs should prioritise areas such as infection control, medication safety, and effective care transitions. Regular audits, feedback loops, and the use of quality improvement tools like Plan-Do-Study-Act (PDSA) cycles can help identify problems, test solutions, and implement successful changes systematically.
Support Interdisciplinary Collaboration
Encouraging collaboration across different healthcare disciplines supports comprehensive patient care. Regular interdisciplinary meetings and case conferences can facilitate communication and coordination among healthcare providers. By fostering a collaborative environment, hospitals can address care gaps more effectively and support staff to consider and manage care appropriately.
The goal is not to eliminate all variation but to reduce unwanted variation that does not add value to consumer care. Some variation is necessary and beneficial, as it allows for personalised care based on individual consumer needs. The strategies recommended in the article, when implemented together, aim to minimise patient outcome discrepancies and enhance overall healthcare quality.
All accessed on 15/06/2024:
van der Linde M, Salet N, van Leeuwen N, et al. Between-hospital variation in indicators of quality of care: a systematic review. BMJ Qual Saf 2024;33:443–55. doi:10.1136/bmjqs-2023-016726