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Biomedical subjects

J Ovretveit

Publications and source records attributed to J Ovretveit.

At least 19 recordsLinked to original sources
PubMed2001

The Norwegian approach to integrated quality development.

The UK NHS quality proposals require all NHS organisations to develop an "integrated approach " to quality. In other countries, health care organisations are also working to ensure that the many different quality methods and systems used in health organisations do not duplicate or conflict with each other. The question this paper addresses is "what would an integrated approach to quality look like and how might managers and clinicians develop such an approach in their organisation?" The findings from the Norwegian total quality management experiment in six hospitals were that TQM could not be applied in its pure form in public health care services to ensure integration. The paper draws on this research to describe these hospitals' approach to integrate the different projects and systems which were stimulated by their initial quality programmes. The paper describes the "integrated quality development" approach which characterised these programmes.

Critical Pathways↗
PubMed1999

A team quality improvement sequence for complex problems.

To solve complex quality problems teams need to follow a systematic sequence of inquiry and action. In this article a practical description of a team quality improvement sequence (TQIS) is given based on the experience of the more successful teams in the Norwegian total quality management experiment. There are nine phases in the sequence and teams have the flexibility to choose the best quality methods for completing each phase. The strengths of the framework are in ensuring that personnel time is used cost effectively and that changes are made which result in measurable improvement. One limitation is that the framework has not been as widely tested as FOCUS-PDCA (find, organise, clarify, understand, select-plan, do, check, act) and other frameworks to which the TQIS framework is compared. It is proposed that if team projects are to be the main vehicle for quality improvement, then their work must be made more cost effective. The article aims to stimulate research into the conditions necessary for different quality teams to be successful in health care, and draws on the research to propose a "risk of team failure index" to improve the management of such teams.

Norway↗
PubMed1998

Medical managers can make research-based management decisions.

The paper has three messages. First, doctors in management can use evaluation methods and research to make better management decisions and to manage projects. Second, health policy makers and managers can no longer afford not to make a greater use of evaluation in making and implementing decisions. Third, the model of evidence-based medicine is not appropriate for management decisions, but there are other approaches which can be used to develop evaluation-informed health management.

Decision Making, Organizational↗
PubMed1997

Would it work for us? Learning from quality improvement in Europe and beyond.

DEVELOPING QUALITY TRANSFER TECHNOLOGY AND TRANSFERABILITY ASSESSMENT: Transferring a method or an approach that works in one organization to another organization may not produce the same effect. The result in one setting is an effect of the method or approach working within that system, not just an effect of the method or approach alone. THE CONTEXT FOR QUALITY IMPROVEMENT (QI): To better understand QI activities in a particular country, five aspects of the QI context need to be considered--the health care system, social values, health reform, history of quality assurance, and the language and politics of quality. For example, differences in terminology, even within one region of a country, undermine transferability of quality approaches and methods. LEARNING FROM OTHERS' SOLUTIONS AND STRATEGIES: The methods used to learn from others can be improved by seeking out reports describing the context of the improvement, by carefully deciding which facilities to visit and which conferences and networking events to attend, and by developing skills in judging transferability and in adapting others' strategies. CONCLUSION: Similar changes in health care in most countries are creating a climate more conducive to QI methods than in the past, and there is more experience with these methods and there are more examples of their successful application. Learning from others has more benefits than finding solutions to one's own quality problems. By examining others' approaches to QI one may become aware of issues that have been ignored or that are latent problems in one's own organization.

Delivery of Health Care↗
PubMed1997

Information for patients about health services: a review and future developments in the Nordic countries.

Patient power, consumerism and the information revolution are leading to more pressure on care givers to provide information to patients. There are many types of information about health services, treatments and health conditions which could be made available, and different ways of giving it to patients and of helping them to use the information. This paper considers the information which would help citizens to choose a provider, as well as the information which patients could use to take a greater part in treatment decisions and to manage their care, and discusses how it could be collected and provided to people. It reviews some of the research into what information people want, how they use it, the different systems which exist, and the problems and issues involved in helping patients to make more informed choices. Although the review is selective, some general themes emerge and suggest that nurses need to experiment with different approaches and to be at the forefront of developments in enabling patients to make use of the new information which is available.

Communication↗
PubMed1996

Beyond the public-private debate: the mixed economy of health.

Can or should private organisations provide public healthcare services? What is the scope for private finance in public healthcare services? This paper reviews some of the arguments for and against public or private ownership management and financing of public healthcare services. It concentrates on health services, where non-economic values and ethical questions are as important as the efficiency considerations, and on health purchasing or funding organisations. The paper describes the increasingly complex interrelationship and forms of competition between public and private providers, purchasers and financiers in the UK health sector. It argues that the simple private/public distinction never did describe well the many different forms of financing ownership and operation of health services in any country and is now a handicap to both scientific and lay policy debate about future options. It proposes a framework for describing the main forms of ownership and operations of health services and considers the future for health service purchasing and funding.

Contract Services↗
PubMed1996

Informed choice? Health service quality and outcome information for patients.

People need information to choose a physician, a hospital, or to take part in a decision about their treatment. There is little knowledge about what information people want or need to make these choices. Yet there is a growing view in Europe that more and better information should be available to the public about service quality and outcomes. This paper considers the collection, analysis and presentation of health service quality and outcome information for use by patients to make decisions about a provider and about a treatment. It considers why this subject is now a public health and policy issue in Europe, reviews experience in the USA and Europe to gathering and giving this information, and describes the technical, socio-political and ethical issues involved. It concludes that whilst advances have been made in overcoming the technical and cost problems, we do not yet know enough about the information which people want or can use to justify large scale publicity schemes. It proposes that global quality information about a hospital or other service as a whole is less useful. Progress is best made on a specialty or treatment basis, especially where there are large unexplained variations, and by involving patient groups in defining the information which patients with specific health conditions most value. It notes how these developments are leading to new types of collaboration between health workers and patients to increase both patient's and professional's knowledge of the course of an illness or treatment.

Europe↗
PubMed1996

Medical participation in and leadership of quality programmes.

Notes that medical participation in organization-wide quality programmes and leadership of quality is commonly viewed as the key to a successful programme. Reviews and reports research into doctors' involvement in such programmes as distinct from doctors' involvement in medical quality activities. Reveals the lack of systematic evidence on the subject, suggests areas for future research, and summarizes what is known. Gives recommendations based on reported research and experience for quality training for doctors and how medical managers might engage their colleagues and other professions in quality programmes.

Education, Continuing↗
PubMed1991

Future organisation of therapy service.

Therapists are considering the best organisation for their services and how to draw up contracts. This article is based on consultancy research into these subjects with physiotherapists, occupational therapists, speech therapists, psychologists, chiropodists, and dietitians. John Ovretveit presents models and a series of steps to help therapists and general managers clarify the options for the future and decide which form of organisation to work towards.

Ancillary Services, Hospital↗
PubMed1991

Costing quality.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMed1990

Making the team work!...

Setting up a multidisciplinary team is not simply a question of calling a group of people a team. It must be properly organised for the individual service--once it is decided the team is needed.

Community Health Services↗