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Table 2 Elements of continuous quality improvements

From: Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana

Element

Description

Systems-view

Emphasis on analysis of the whole system providing a service, or influencing an outcome

Customer focus

Emphasis on both customer (patient, provider, payer) satisfaction and health outcomes as performance measures

Data-driven analysis

Emphasis on gathering and use of objective data on system operations and system performance

Implementer involvement

Emphasis on involving the owners of all components of the system in seeking a common understanding of its delivery process

Multiple causation

Emphasis on identifying the multiple root causes of a set of system phenomena

Solution identification

Emphasis on seeking a set of solutions that enhance overall system performance though simultaneous improvements in a number of normally independent functions

Process optimisation

Emphasis on optimising a delivery process to meet customer needs regardless of existing precedents, and on implementing the system changes regardless of existing territories and fiefdoms

Continuing improvement

Emphasis on continuing the systems analysis, even when a satisfactory solution to the presenting problem is obtained

Organisational learning

Emphasis on organisational learning so that the capacity of the organisation to generate process improvement and foster personal growth is enhanced

  1. (Adapted from McLaughlin and Kaluzny, 1994[13]).