Biomaterial Database

Organizational barriers to quality improvement in medical and health care organizations. 1991

J T Ziegenfuss

Graduate Program in Public Administration, Pennsylvania State University at Harrisburg, Middletown 17507.

This paper identifies organizational barriers to quality improvement in medical and health care organizations. Quality is now recognized as one of the most challenging issues of the 1990s. The push for quality improvement rests on the significant assumption that large and small medical and health care organizations will engage in quality assessment and assurance. Both researchers and practitioners must consider the organizational barriers the quality movement will encounter, particularly those major impediments to be overcome in the next 5-10 years. This paper organizes the analysis of organizational barriers to quality assessment and assurance according to a five-part systems model of the organization. The barriers are categorized as technical, structural, psychosocial, managerial, and goals and values. Following a mapping of the barriers, education, training, and research and development needs to support quality improvement are identified.

UI	MeSH Term	Description	Entries
D007857	Leadership	The function of directing or controlling the actions or attitudes of an individual or group with more or less willing acquiescence of the followers.	Influentials
D008962	Models, Theoretical	Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.	Experimental Model,Experimental Models,Mathematical Model,Model, Experimental,Models (Theoretical),Models, Experimental,Models, Theoretic,Theoretical Study,Mathematical Models,Model (Theoretical),Model, Mathematical,Model, Theoretical,Models, Mathematical,Studies, Theoretical,Study, Theoretical,Theoretical Model,Theoretical Models,Theoretical Studies
D009936	Organizational Innovation	Introduction of changes which are new to the organization and are created by management.	Organizational Change,Change, Organizational,Innovation, Organizational,Changes, Organizational,Innovations, Organizational,Organizational Changes,Organizational Innovations
D011209	Power, Psychological	The exertion of a strong influence or control over others in a variety of settings--administrative, social, academic, etc.	Power (Psychology),Power, Personal,Power, Professional,Power, Social,Power,Personal Power,Powers, Psychological,Professional Power,Psychological Power,Psychological Powers,Social Power
D011785	Quality Assurance, Health Care	Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.	Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D004059	Diffusion of Innovation	The broad dissemination of new ideas, procedures, techniques, materials, and devices and the degree to which these are accepted and used.	Innovation Diffusion,Diffusion, Innovation
D006123	Group Practice	Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.	Group Practices,Practice, Group,Practices, Group
D006279	Health Maintenance Organizations	Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)	Group Health Organizations, Prepaid,HMO,Prepaid Group Health Organizations,Health Maintenance Organization,Organizations, Health Maintenance,Organization, Health Maintenance
D006739	Hospital Administration	Management of the internal organization of the hospital.	Hospital Organization and Administration,Organization and Administration, Hospital,Administration, Hospital
D001291	Attitude of Health Personnel	Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.	Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes