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A systemic view of constructing a su...

Collado, Carol B.

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A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution.

Record Type:	Electronic resources : Monograph/item
Title/Author:	A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution./
Author:	Collado, Carol B.
Description:	185 p.
Notes:	Source: Dissertation Abstracts International, Volume: 63-07, Section: B, page: 3215.
Contained By:	Dissertation Abstracts International63-07B.
Subject:	Health Sciences, Human Development. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3059654
ISBN:	0493750568

A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution.
Collado, Carol B.

A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution. - 185 p.

Source: Dissertation Abstracts International, Volume: 63-07, Section: B, page: 3215.

Thesis (Ph.D.)--Fielding Graduate Institute, 2002.

This case study examined the participatory system-wide change process of constructing a sustainable institutional program of improving quality of health care in a large maternity hospital in a developing country over a period of 6 years. A qualitative analysis, based on interview and archival data, demonstrated that change, even in difficult circumstances and with limited resources, is possible. Institutionally, the process resulted in the development of a learning organization. Results were shown in attention for patients, organizational development, the role of the hospital within the community, and types of services offered. The research also documented the perceived effects of participating in this process as reported by the persons involved. Especially notable were individual changes in empowerment, responsibility, accountability, commitment, humanization, team workstyle, and in the vision of care and quality. Improving quality in health care was demonstrated to be a complex multidimensional phenomenon, requiring action on many different levels to achieve change. The combination of individual and organizational development, leadership, communication, feedback, competition, and capacity building processes combined to create a new model for improving quality that exemplified a social construction approach to the change process. The fact that the effort was system-wide exercised a cohesive force, permitting a greater sense of institutional identity and direction to the totality of the proceedings. The combination of the different processes appear to be the pillars of enabling sustainability and creating a self-renewing process. Several individual aspects also emerged as important in this experience: (a) the relationship of the institution and participants with the internal and external institutional environment; (b) the consideration of the hospital staff as internal consumers, a strategy that validated their input as well as that of the patients and community; (c) the role of the external facilitator; and (d) the development of action-reflection as the preferred workstyle, enabling the progressive changes in the conceptual bases to direct action and transform the situation, a true paradigm change.

ISBN: 0493750568Subjects--Topical Terms:

1019218
Health Sciences, Human Development.

A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution.
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245 1 0 $a A systemic view of constructing a sustainable quality of care improvement initiative: A case study of process and outcomes in a participatory change experience in a developing country institution.
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500 $a Source: Dissertation Abstracts International, Volume: 63-07, Section: B, page: 3215.
500 $a Chair: Don D. Bushnell.
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520 $a This case study examined the participatory system-wide change process of constructing a sustainable institutional program of improving quality of health care in a large maternity hospital in a developing country over a period of 6 years. A qualitative analysis, based on interview and archival data, demonstrated that change, even in difficult circumstances and with limited resources, is possible. Institutionally, the process resulted in the development of a learning organization. Results were shown in attention for patients, organizational development, the role of the hospital within the community, and types of services offered. The research also documented the perceived effects of participating in this process as reported by the persons involved. Especially notable were individual changes in empowerment, responsibility, accountability, commitment, humanization, team workstyle, and in the vision of care and quality. Improving quality in health care was demonstrated to be a complex multidimensional phenomenon, requiring action on many different levels to achieve change. The combination of individual and organizational development, leadership, communication, feedback, competition, and capacity building processes combined to create a new model for improving quality that exemplified a social construction approach to the change process. The fact that the effort was system-wide exercised a cohesive force, permitting a greater sense of institutional identity and direction to the totality of the proceedings. The combination of the different processes appear to be the pillars of enabling sustainability and creating a self-renewing process. Several individual aspects also emerged as important in this experience: (a) the relationship of the institution and participants with the internal and external institutional environment; (b) the consideration of the hospital staff as internal consumers, a strategy that validated their input as well as that of the patients and community; (c) the role of the external facilitator; and (d) the development of action-reflection as the preferred workstyle, enabling the progressive changes in the conceptual bases to direct action and transform the situation, a true paradigm change.
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