The EFQM excellence model is useful for primary health care teams

BACKGROUND: Primary care teams are facing an increased need to develop quality programmes at local level. GPs must lead this process and promote a positive organizational culture if they want to achieve and maintain a continuous improvement of the service. OBJECTIVE: The aim of the present study was to test the applicability and reliability of the European Foundation for Quality Management (EFQM) excellence model self-assessment questionnaire in a primary health care organization. METHOD: A cross-sectional study was carried out of the EFQM questionnaire to compare the scores achieved by a primary health care team in Spain caring for 42 000 inhabitants using internal self-assessment with the scores achieved by professional management auditors through an external audit. RESULTS: The scores of each criterion achieved by self-evaluation are similar to or lower than those assessed by the external evaluation. There is agreement in the areas suitable for improvement. CONCLUSIONS: The experience proves the applicability of the EFQM excellence model for primary health care teams and its reliability, at least when the team undergoing self-assessment know they are going to be re-evaluated. There is high concordance in the identification of areas for improvement.     

A two-level EFQM self-assessment in an Italian hospital

PURPOSE: An assessment of the EFQM excellence model was carried out in Italy's Udine Hospital, aimed at evaluating how first and second-level managers perceived their hospital and individual departments. The study objectives also included identifying strengths and areas requiring improvement and stimulating a quality culture. DESIGN/METHODOLOGY/APPROACH: Udine's S. Maria della Misericordia Hospital is a large specialised unit in North East Italy and similar to many regional hospitals throughout the country. The survey is a single case study of the hospital and its ten clinical departments. A 153-item questionnaire was completed by 201 experienced respondents. FINDINGS: Leadership, policy and strategy, partnership and resources were rated highly, whereas people, society and customer results received lower ratings. Several improvement actions were planned, primarily with regard to the results criteria. PRACTICAL IMPLICATIONS: A two-level self-assessment was successfully carried out in a hospital, giving insight into the organisation's strengths and areas requiring improvement. Through the study, a systemic approach was introduced and quality awareness was heightened. ORIGINALITY/VALUE: The findings are useful for other hospitals conducting EFQM self-assessment.     

A proposed adaptation of the EFQM fundamental concepts of excellence to health care based on the PATH framework.

OBJECTIVE: The use of the European Foundation for Quality Management (EFQM) Model in health care has found that this model is useful in promoting quality improvement, but its use in health care organizations is challenging because being a generic model, it does not cover the clinical aspects or the specifics of this field. For that reason, this article aims to bring the EFQM fundamental concepts of excellence closer to health care, using a specific model as a reference to this field: the Performance Assessment Tool for quality improvement in Hospitals (PATH) conceptual framework, developed by the WHO Regional Office for Europe. METHOD: A content analysis was performed to independently identify the contents that defined the elements of both frameworks. Then, using defined criteria, two independent researchers compared the contents of the elements of both frameworks. The elements from both frameworks that were equivalent were aggregated. Several experts discussed the aspects with discrepancies between the two comparisons. Finally, the EFQM framework is adapted to health care by adding to those aggregated elements the aspects that were exclusive from one of the models. RESULTS: The EFQM framework has many correspondences to a health care-specific framework. The EFQM-health care-adapted framework has eight quality dimensions, two of them (customer focus and safety) being overlapped with the other six (staff, results orientation, responsive governance, leadership and constancy of purpose, clinical effectiveness, and partnership development). This model also has two methodological dimensions (management by processes and facts and continuous learning; improvement and innovation). CONCLUSION: This adapted model seems useful for health care organizations, but it needs to be further used to corroborate this preliminary finding.     

The EFQM Excellence Model. German experiences with the EFQM approach in health care.

OBJECTIVE: To expand on previous reports by illustrating experiences German health services organizitions made in their assessment against the European Foundation for Quality Management (EFQM) Excellence Model. To provide an evaluation of the EFQM method compared to peer auditing and accreditation concepts within health care. DESIGN: To indicate the EFQM method and scoring system and draft the process of self-assessment in health services organizitions. To refer to the experiences of German health care pioneers during their early assessments. RESULTS: Using the EFQM approach, an organizition can earn up to 1.000 points. More than 50% of German hospitals scored 200-300 points and not a single organizition achieved over 450 points. To make a comparison, the best score obtained in an industrial setting was between 650-750 points. In addition to the numbers, this report describes success factors and best practices of self-assessments, as well as limitations, barriers and lessons learned during the implementation phase. CONCLUSION: The Excellence Model is a systematic quality management approach to gain competitive advantage. It is non-governmental, non-financier driven, and generic enough to address health care issues. Having its foundation in industry, however, it is not specific enough to cover all areas relevant to health care. Integrating the management-smart method of self-assessment with clinical standards as delivered by peer auditing and accreditation systems generates the potential to deliver excellence in health care.     

Clinical governance is "ACE"--using the EFQM excellence model to support baseline assessment

The introduction of clinical governance in the "new NHS" means that National Health Service (NHS) organisations are now accountable for the quality of the services they provide to their local communities. As part of the implementation of clinical governance in the NHS, Trusts and health authorities had to complete a baseline assessment of their capability and capacity by September 1999. Describes one Trust's approach to developing and implementing its baseline assessment tool, based upon its existing use of the European Foundation for Quality Management (EFQM) Excellence Model. An initial review of the process suggests that the model provides an adaptable framework for the development of a comprehensive and practical assessment tool and that self-assessment ensures ownership of action plans at service level.     

新冠疫情背景下社区医护人员公共卫生应急能力自我认知调查

目的 通过对新冠疫情背景下社区医护人员公共卫生应急能力的调查分析,并分析其主要影响因素,以期为政府卫生决策、医院管理决策等提供参考。方法 对广州市越秀区所有社区卫生服务中心的838名医护人员开展匿名问卷调查,被调查者根据自身实际情况进行公共卫生应急能力自评;对数据采用单因素方差分析和多元线性回归分析识别主要影响因素。结果 问卷有效回收率99.16%;全区医护人员平均得分为193.23±30.56,公共卫生应急能力整体较好,各维度中“预防能力”得分最低;多元回归分析结果显示“是否具有应急救援经历”是其最大影响因素(F=14.617, P＜0.001),其次是“应急培训经历”和“综合性医院工作经验”(F=14.617, P＜0.001)。结论 后疫情时代应重点提升公共卫生应急预防能力,定期组织医护人员开展应急救援培训演习、经验交流;优化基层社区资源配置,落实医护人员人文关怀;多方配合共建防御壁垒,提高居民应急救援能力与意识。     

The EFQM excellence model: European and Dutch experiences with the EFQM approach in health care. European Foundation for Quality Management.

One way to meet the challenges in creating a high performance organization in health care is the approach of the European Foundation for Quality Management (EFQM). The Foundation is in the tradition of the American Malcolm Baldrige Award and was initiated by the European Commission and 14 European multi-national organizations in 1988. The essence of the approach is the EFQM Model, which can be used as a self-assessment instrument on all levels of a health care organization and as an auditing instrument for the Quality Award. In 1999 the EFQM Model was revised but its principles remained the same. In The Netherlands many health care organizations apply the EFQM Model. In addition to improvement projects, peer review of professional practices, accreditation and certification, the EFQM Approach is used mainly as a framework for quality management and as a conceptualization for organizational excellence. The Dutch National Institute for Quality, the Instituut Nederlandse Kwaliteit, delivers training and supports self-assessment and runs the Dutch quality award programme. Two specific guidelines for health care organizations, 'Positioning and Improving' and 'Self-Assessment', have been developed and are used frequently. To illustrate the EFQM approach in The Netherlands, the improvement project of the Jellinek Centre is described. The Jellinek Centre conducted internal and external assessments and received in 1996, as the first health care organization, the Dutch Quality Prize.     

Health staff perception regarding quality of delivered information to inpatients.

BACKGROUND: Accreditation usually requires that healthcare staff assess the quality of care delivered to patients in their own hospitals. It is unknown whether this assessment depends on the workplace rather than on the professional category of health personnel. OBJECTIVE: We aimed to identify major determinants of the perception of various categories of healthcare professionals concerning the quality of delivered information to inpatients in their ward, with a perspective to help the development of recommendations on how to compose self-assessment teams for the accreditation process. METHOD: A self-administered questionnaire survey was conducted in nine wards from five short-stay hospitals in Paris, France. Three hundred and fifteen healthcare professionals (physicians, nurses and nursing assistants) were included. The views of various categories of healthcare professionals regarding the compliance with a set of quality standards were compared by nonparametric statistical analyses. Determinants of the self-assessment of quality of care, including ward effect, were identified by fitting the data to a hierarchical model. RESULTS: The participation rate was 86%, with 272 respondents (58 physicians, 149 nurses and 65 nursing assistants). Overall perceptions of various categories of healthcare professionals were not different. The final hierarchical model showed a strong ward effect (intracluster correlation coefficient=0.06, P<0.01) and a significant relationship between age of professionals and their opinion about quality of care. CONCLUSION: We observed a ward cluster effect on healthcare staff perception of quality, but the category of healthcare professional was not a determinant. A satisfactory representativeness on age of professionals selected into the teams in charge of self-assessment during hospital accreditation is recommended.     

应用护理行政查房以提高管理水平和护理质量

目的探析护理行政查房在提高管理水平和护理质量中的应用效果。方法选取160例本院住院患者,入选时间2018年4月-2019年5月,随机分为两组,对照组80例行常规护理管理,观察组80例行护理行政查房管理。对两组满意度、护士能力评分、护理质量、管理水平进行对比观察。结果观察组满意度97.50%、护士能力(86.53±4.15)分、健康教育(16.24±1.24)分、病房管理(75.42±3.25)分、护理技术操作(97.46±2.75)分、专科护理(95.82±5.86)分、基础护理(95.65±5.40)分、管理水平(41.64±3.15)分均高于对照组81.25%、(75.52±11.90)分、(13.89±1.29)分、(66.23±3.09)分、(91.32±3.03)分、(87.72±5.82)分、(84.37±5.02)分、(36.43±5.51)分,对比差异有统计学意义(P <0.05)。结论实施护理行政查房后,各科室人员自我素质有所提升,管理水平有所改善,服务认可度、护理质量有所提升。