http://qshc.bmj.com/cgi/content/abstract/18/Suppl_1/i22?etoc


Quality and Safety in Health Care 2009;18(Suppl 1):i22-i27;
doi:10.1136/qshc.2008.029355
Copyright © 2009 by the BMJ Publishing Group Ltd.

National quality improvement policies and strategies in European healthcare
systems
E Spencer, K Walshe

Herbert Simon Institute for Public Policy and Management, Manchester
Business School, Manchester, UK


Correspondence to:
Professor K Walshe, Harold Hankins Building, Manchester Business School,
Booth Street West, Manchester M15 6PB, UK; kieran.walshe@...

Objective: This survey provides an overview of the development of policies
and strategies for quality improvement in European healthcare systems, by
mapping quality improvement policies and strategies, progress in their
implementation, and early indications of their impact.

Study design: A survey of quality improvement policies and strategies in
healthcare systems of the European Union was conducted in 2005 for the first
phase of the Methods of Assessing Response to Quality Improvement Strategies
(MARQuIS) project.

Participants: The survey, completed by 68 key experts in quality improvement
from 24 European Union member states, represents their views and accounts of
quality improvement policies and strategies in their healthcare systems.

Principal findings: There are substantial international and intra-national
variations in the development of healthcare quality improvement. Legal
requirements for quality improvement strategies are an important driver of
progress, along with the activities of national governments and professional
associations and societies. Patient and service user organisations appear to
have less influence on quality improvement. Wide variation in voluntary and
mandatory coverage of quality improvement policies and strategies across
sectors can potentially lead to varying levels of progress in
implementation. Many healthcare organisations lack basic infrastructure for
quality improvement.

Conclusions: Some convergence can be observed in policies on quality
improvement in healthcare. Nevertheless, the growth of patient mobility
across borders, along with the implications of free market provisions for
the organisation and funding of healthcare systems in European Union member
states, require policies for cooperation and learning transfer.



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