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BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2015 | Research article

The impact of redesigning care processes on quality of care: a systematic review

Authors: Janneke E. van Leijen-Zeelenberg, Arianne M. J. Elissen, Kerstin Grube, Arno J. A. van Raak, Hubertus J. M. Vrijhoef, Bernd Kremer, Dirk Ruwaard

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

This literature review evaluates the current state of knowledge about the impact of process redesign on the quality of healthcare.

Methods

Pubmed, CINAHL, Web of Science and Business Premier Source were searched for relevant studies published in the last ten years [2004–2014]. To be included, studies had to be original research, published in English with a before-and-after study design, and be focused on changes in healthcare processes and quality of care. Studies that met the inclusion criteria were independently assessed for excellence in reporting by three reviewers using the SQUIRE checklist. Data was extracted using a framework developed for this review.

Results

Reporting adequacy varied across the studies. Process redesign interventions were diverse, and none of the studies described their effects on all dimensions of quality defined by the Institute of Medicine.

Conclusions

The results of this systematic literature review suggests that process redesign interventions have positive effects on certain aspects of quality. However, the full impact cannot be determined on the basis of the literature. A wide range of outcome measures were used, and research methods were limited. This review demonstrates the need for further investigation of the impact of redesign interventions on the quality of healthcare.
Appendix
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Literature
1.
Hofmarcher MM, Oxley H, Rusticelli E. Improved Health System Performance Through Better Care Coordination. OECD Health Working Paper No 30. Paris: The Organisation for Economic Co-operation and Development; 2007.CrossRef
2.
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press; 2001.
3.
OECD. Health at a Glance: Europe 2012. Paris: The Organisation for Economic Co-operation and Development; 2012.
4.
Fuchs VR, Emanuel EJ. Health care reform: Why? What? When? Health Aff. 2005;24(6):1399–414.CrossRef
5.
Institute of Medicine. Performance Measurement: Accelerating Improvement. Washington, D.C.: Institute of Medicine; 2006.
6.
Elkhuizen SG, Limburg M, Bakker PJ, Klazinga NS. Evidence-based re-engineering: re-engineering the evidence. A systematic review of the literature on business process redesign (BPR) in hospital care. Int J Health Care Qual Assur. 2006;19(6–7):477–99.CrossRef
7.
Vest JR, Gamm LD. A critical review of the research literature on Six sigma, lean and StuderGroup’s hardwiring excellence in the united states: the need to demonstrate and communicate the effectiveness of transformation strategies in healthcare. Impl Sc. 2009;4:35.CrossRef
8.
Harmon P, Business Process Change. A manager’s guide to improving, redesigning and automating processes. San Francisco, CA: Morgan Kaufmann Publishers; 2003.
9.
Donabedian A. An introduction to Quality Assurance. In: Bashshur R, editor. Health Care. Oxford: University Press; 2003.
10.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.CrossRefPubMedPubMedCentral
11.
Ogrinc G, Mooney SE, Estrada C, Foster T, Goldmann D, Hall LW, et al. The SQUIRE [Standards for Quality Improvement Reporting Excellence] guidelines for quality improvement reporting: explanation and elaboration. Qual Saf Health Care. 2008;17 Suppl 1:i13–32.CrossRefPubMedPubMedCentral
12.
Wood DL, Brennan MD, Chaudhry R, Chihak AA, Feyereisn WL, Woychick NL, et al. Standardized care processes to improve quality and safety of patient care in a large academic practice: the Plummer Project of the Department of Medicine, Mayo Clinic. Health Serv Manage Res. 2008;21(4):276–80.CrossRefPubMed
13.
Auerbach AD, Wachter RM, Cheng HQ, Maselli J, McDermott M, Vittinghoff E, et al. Comanagement of surgical patients between neurosurgeons and hospitalists. Arch Int Med. 2010;13;170(22):2004–10.CrossRef
14.
Kelly AM, Bryant M, Cox L, Jolley D. Improving emergency department efficiency by patient streaming to outcomes-based teams. Aust Health Rev. 2007;31(1):16–21.CrossRefPubMed
15.
Kim CS, Hayman JA, Billi, JE, Lash K, Lawrence TS. The application of lean thinking to the care of patients with bone and brain metastasis with radiation therapy. J Oncol Pract. 2007;3(4):189–93.CrossRefPubMedPubMedCentral
16.
Krening CF, Rehling-Anthony K, Garko C. Oxytocin administration: the transition to a safer model of care. J Perinat Neonat Nur. 2012;26(1):15–24.CrossRef
17.
Liss DT, Fishman PA, Rutter CM, Grembowski D, Ross TR, Johnson EA, et al. Outcomes among chronically Ill adults in a medical home prototype. Am J Manag Care. 2013;19(10):E348−+.PubMedPubMedCentral
18.
Murray O, Christen K, Marsh A, Bayer J. Fracture clinic redesign: improving standards in patient care and interprofessional education. Swiss Med Wkly. 2012;142:w13630.PubMed
19.
Ravikumar TS, Sharma C, Marini C, Steele GD Jr, Ritter G, Barrera R, et al. A validated value-based model to improve hospital-wide perioperative outcomes: adaptability to combined medical/surgical inpatient cohorts. Ann Surg. 2010;252(3):486–96. discussion 96–8.PubMed
20.
Reid RJ, Fishman PA, Yu O, Ross TR, Tufano JT, Soman MP, et al. Patient-centered medical home demonstration: a prospective, quasi-experimental, before and after evaluation. Am J Manag Care. 2009;15(9):E71–87.PubMed
21.
Shannon RP, Frndak D, Grunden N, Lloyd JC, Herbert C, Patel B, et al. Using real-time problem solving to eliminate central line infections. Jt Comm J Qual Patient Saf. 2006;32(9):479–87.CrossRefPubMed
22.
Shendel-Falik N, Feinson M, Mohr BJ. Enhancing patient safety - Improving the patient handoff process through appreciative inquiry. J Nurs Admin. 2007;37(2):95–104.CrossRef
23.
Hwang TG, Lee Y, Shin H. Structure-oriented versus process-oriented approach to enhance efficiency for emergency room operations: what lessons Can We learn? J Healthc Manag. 2011;56(4):255–67.PubMed
24.
King DL, Ben-Tovim DI, Bassham J. Redesigning emergency department patient flows: application of lean thinking to health care. Emerg Med Australas. 2006;18(4):391–7.CrossRefPubMed
25.
Raab SS, Andrew-Jaja C, Condel JL, Dabbs DJ. Improving Papanicolaou test quality and reducing medical errors by using Toyota production system methods. Am J Obstet Gynecol. 2006;194(1):57–64.CrossRefPubMed
26.
Raab SS, Grzybicki DM, Condel JL, Stewart WR, Turcsanyi BD, Mahood LK, et al. Effect of Lean method implementation in the histopathology section of an anatomical pathology laboratory. J Clin Pathol. 2008;61(11):1193–9.CrossRefPubMed
27.
Raab SS, Grzybicki DM, Sudilovsky D, Balassanian R, Janosky JE, Vrbin CM. Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error. Am J Clin Pathol. 2006;126(4):585–92.CrossRefPubMed
28.
Collar RM, Shuman AG, Feiner S, McGonegal AK, Heidel N, Duck M, et al. Lean management in academic surgery. J Am Coll Surg. 2012;214(6):928–36.CrossRefPubMed
29.
Pennell L, Smith-Snyder CM, Hudson LR, Hamar GB, Westerfield J. Practice changes in glycemic management and outcomes in coronary artery bypass surgery patients. J Cardiovasc Nurs. 2005;20(1):26–34.CrossRefPubMed
30.
Dimitrov DM, Rumrill Jr PD. Pretest-posttest designs and measurement of change. Work. 2003;20(2):159–65.PubMed
31.
Shojania KG, Grimshaw JM. Evidence-based quality improvement: the state of the science. Health Aff. 2005;24(1):138–50.CrossRef
32.
33.
Nolte E, Conklin A, Adams J, Brunn M, Cadier B, Chevreul K, et al. Evaluating chronic disease management. Recommendations for funders and users. Santa Monica, CA: RAND Corporation; 2012.
34.
35.
Mazzocato P, Savage C, Brommels M, Aronsson H, Thor J. Lean thinking in healthcare: a realist review of the literature. Qual Saf Health Care. 2010;19(5):376–82.PubMed
36.
Schouten LM, Hulscher ME, van Everdingen JJ, Huijsman R. Grol RP: evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008;336(7659):1491–4.CrossRefPubMedPubMedCentral
37.
Jackson GL, Powers BJ, Chatterjee R, Bettger JP, Kemper AR, Hasselblad V, et al. Improving patient care. The patient centered medical home. A systematic review. Ann Intern Med. 2013;158(3):169–78.CrossRefPubMed
38.
Chalmers I, Glasziou P, Godlee F. All trials must be registered and the results published. BMJ. 2013;346:f105.CrossRefPubMed
Metadata
Title
The impact of redesigning care processes on quality of care: a systematic review
Authors
Janneke E. van Leijen-Zeelenberg
Arianne M. J. Elissen
Kerstin Grube
Arno J. A. van Raak
Hubertus J. M. Vrijhoef
Bernd Kremer
Dirk Ruwaard
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1266-0

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