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            "creatorSummary": "Yu T.-H. and Chung K.-P.",
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            "title": "Is the implementation of quality improvement methods in hospitals subject to the neighbourhood effect?.",
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                    "lastName": "Yu T.-H."
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                    "lastName": "Chung K.-P."
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            "abstractNote": "Objective: Quality improvement (QI) methods have been fashionable in hospitals for decades. Previous studies have discussed the relationships between the implementation of QI methods and various external and internal factors, but there has been no examination to date of whether the neighbourhood effect influences such implementation. The aim of this study was to use a multilevel model to investigate whether and how the neighbourhood effect influences the implementation of QI methods in the hospital setting in Taiwan. Design: This is a retrospective questionnaire-based survey. Setting: All medical centres, regional hospitals and district teaching hospitals in Taiwan. Participants: Directors or persons in charge of implementing QI methods in hospitals. Intervention(s): None. Main Outcome Measure(s): The breadth and depth of QI method implementation. Results: Seventy-two of the 139 hospitals contacted returned the questionnaire, yielding a 52% response rate. The breadth and depth of QI method implementation increased over the 10-year study period, particularly between 2004 and 2006. The breadth and depth of the QI methods implemented in the participating hospitals were significantly associated with the average breadth and depth of those implemented by their competitors in the same medical area during the previous period. In addition, time was positively associated with the breadth and depth of QI method implementation. Conclusions: In summary, the findings of this study show that hospitals' QI implementation status is influenced by that of their neighbours. Hence, the neighbourhood effect is an important factor in understanding hospital behaviour. The Author 2014. Published by Oxford University Press in association with the International Society for Quality in Health Care all rights reserved.",
            "publicationTitle": "Journal for Quality in Health Care",
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            "DOI": "http://dx.doi.org/10.1093/intqhc/mzu029",
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            "abstractNote": "Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician s ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. 2014 by Lippincott Williams & Wilkins.",
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            "abstractNote": "Setting up a successful trauma system requires a significant amount of hospital support. This includes personnel and programs to assist with quality assurance programs, clinical compliance, and rural support and development. It is imperative that orthopaedic trauma surgeons are well versed in the types of hospital support available and the costs associated with each support measure. With this understanding, a strong, sustainable physician-hospital relationship can be created. 2014 by Lippincott Williams & Wilkins.",
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            "abstractNote": "The perspective of innovation as the strategic lever of organizational performance has been widespread in the hospital sector. While public value of innovation can be significant, it is not evident that innovation always ends up in higher levels of performance. Within this context, the purpose of the article was to critically analyze the relationship between innovation and performance,taking into account the specificities of the hospital sector. This article pulls together primary data on organizational flexibility, innovation, and performance from 95 hospitals in Portugal,collected through a survey, data from interviews to hospital administration boards, and a panel of 15 experts. The diversity of data sources allowed for triangulation. The article uses mixed methods to explore the relationship between innovation and performance in the hospital sector in Portugal. The relationship between innovation and performance is analyzed through cluster analysis, supplemented with content analysis of interviews and the technical nominal group. The main findings reveal that the cluster of efficient innovators has twice the level of performance than other clusters. Organizational flexibility and external cooperation are the 2 major factors explaining these differences. The article identifies various organizational strategies to use innovation in order to enhance hospital performance. Overall, it proposes the alignment of perspectives of different stakeholders on the value proposition of hospital services, the embeddedness of information loops, and continuous adjustments toward high-value services.",
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            "abstractNote": "Productivity is NOT the same as quality. Productivity is about the value-add we bring to work, to each job, to each day. To create a productive hospital environment, it is so much more than buying the right equipment or hiring the right mix of people. Productivity comes from investing in our people and giving them the tools and authority to do their jobs effectively. Adding more \"quality programmes\" can actually kill productivity by taking people away from their core jobs. Adding a tick-list in the operating theatre can cut mortality rates in half by eliminating the smallest of mistakes. This article is a guide to help you focus on the key elements of productivity and not to get distracted by the hype and confusion from media. Its bottom-line focus and \"how-to\" tools and ideas make it useful and practical.",
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