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Place and Role of Quality and Safety Indicators in Hospitals
Funder: French National Research Agency (ANR)Project code: ANR-10-BLAN-1820
Funder Contribution: 238,400 EUR

Background Different countries have launched national reporting programs on hospitals based on quality and safety measurements. Beyond technical definitions, a key-issue is to ensure that an effective improvement is ensured due to the implementation of these measurements. However, the hypothesis that an indicator spontaneously induces such an improvement is not so clear. During the implementation phase can be considered a relation between the indicator, the hospital‘s organisation of work, and the actors who composed it. On this relation depends the real use of the indicator, and consequently its impact in terms of improvement. This project addresses this issue of the use of quality and safety measurements. Objectives The objectives are twofold: 1. Analysis of the indicator as a pertinent assessment system for improving quality 2. Analysis of the indicators‘ roles. The objective is to understand how the relation between quality and safety measurements, sensemaking given by professionals, and the organisation of work generates different roles. Methods The field of analysis is based on a French national program of indicators, Compaqh, which tests 43 indicators on a hospital panel (n= 44 à 100, depending on the topic). The methodology is qualitative, comprehensive, and comparative with a Canadian initiative. The research team is composed of representatives of two disciplinary fields: management science and psychology of work. The duration of the research is three years. Two types of seminars are considered: empirical (follow-up of the data collection process) and contributory (data analysis). Expected Results This project can produce a new knowledge on the relation between quality and safety measurements, sensemaking and organisation of work. It can also help to understand how measurements can construct an adequate representation of the organisation of work. Based on the results, operational recommendations could be developed in order to: - Identify quality and safety topics that can be assessed through measurement - Consider appropriate actions of quality improvement - Optimise the design of Quality and Safety indicators as well as the implantation phase

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