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. 2009 Feb;18 Suppl 1(Suppl_1):i28-37.
doi: 10.1136/qshc.2008.029363.

Application of quality improvement strategies in 389 European hospitals: results of the MARQuIS project

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Application of quality improvement strategies in 389 European hospitals: results of the MARQuIS project

M J M H Lombarts et al. Qual Saf Health Care. 2009 Feb.

Abstract

Context: This study was part of the Methods of Assessing Response to Quality Improvement Strategies (MARQuIS) research project investigating the impact of quality improvement strategies on hospital care in various countries of the European Union (EU), in relation to specific needs of cross-border patients.

Aim: This paper describes how EU hospitals have applied seven quality improvement strategies previously defined by the MARQuIS study: organisational quality management programmes; systems for obtaining patients' views; patient safety systems; audit and internal assessment of clinical standards; clinical and practice guidelines; performance indicators; and external assessment.

Methods: A web-based questionnaire was used to survey acute care hospitals in eight EU countries. The reported findings were later validated via on-site survey and site visits in a sample of the participating hospitals. Data collection took place from April to August 2006.

Results: 389 hospitals participated in the survey; response rates varied per country. All seven quality improvement strategies were widely used in European countries. Activities related to external assessment were the most broadly applied across Europe, and activities related to patient involvement were the least widely implemented. No one country implemented all quality strategies at all hospitals. There were no differences between participating hospitals in western and eastern European countries regarding the application of quality improvement strategies.

Conclusions: Implementation varied per country and per quality improvement strategy, leaving considerable scope for progress in quality improvements. The results may contribute to benchmarking activities in European countries, and point to further areas of research to explore the relationship between the application of quality improvement strategies and actual hospital performance.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Structure of the MARQuIS questionnaire. AMI, acute myocardial infarction; QI, quality improvement.

References

    1. European Court of Justice. Case C-158/96; Raymond Kohll v Union des Caisses de Maladie. 1998 Apr 28;
    1. European Court of Justice. Case C-120/95; Nicolas Decker v Caisse de Maladie des Employes Prives. 1998 Apr 28;
    1. Kanavos P, McKee M, Richards T. Cross border health care in Europe. BMJ 1999;318:1157–8 - PMC - PubMed
    1. Spencer E, Walshe K. Health Care Quality Strategies in Europe. A survey of quality improvement policies and strategies in health care systems of member states of the European Union. Dec 2005, MARQuIS, project no. 513712.
    1. Spencer E, Walshe K. Strategies: literature and interview summary. Quality Improvement Strategies in Healthcare systems of the European Union. April 2005. MARQuIS, project no. 513712.

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