Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)
169 Downloads (Pure)

Abstract

Objectives
Given the impact of the global economic crisis, delivering better health care with limited finance grows more challenging. Through the lens of institutional theory, this paper explores pressures experienced by hospital leaders to improve quality and constrain spending, focusing on how they respond to these often competing demands.
Methods
An in-depth, multilevel analysis of health care quality policies and practices in five European countries including longitudinal case studies in a purposive sample of ten hospitals.
Results
How hospitals responded to the financial and quality challenges was dependent upon three factors: the coherence of demands from external institutions; managerial competence to align external demands with an overall quality improvement strategy, and managerial stability. Hospital leaders used diverse strategies and practices to manage conflicting external pressures.
Conclusions
The development of hospital leaders’ skills in translating external requirements into implementation plans with internal support is a complex, but crucial, task, if quality is to remain a priority during times of austerity. Increasing quality improvement skills within a hospital, developing a culture where quality improvement becomes embedded and linking cost reduction measures to improving care are all required.
Original languageEnglish
JournalJournal of health services research & policy
DOIs
Publication statusE-pub ahead of print - 17 Dec 2015

Fingerprint

Dive into the research topics of 'Using institutional theory to analyse hospital responses to external demands for finance and quality in five European countries'. Together they form a unique fingerprint.

Cite this