PROBLEM In hospitals in rural, resource-limited settings, there is an acute need for simple, practical strategies to improve healthcare quality. SETTING A district hospital in remote western Nepal. KEY MEASURES FOR IMPROVEMENT To provide a mechanism for systems-level reflection so that staff can identify targets for quality improvement in healthcare delivery. Strategies for change To develo...

The downsizing movement left fractures in the healthcare system for patients, nurses, and healthcare providers. To heal the fractures, nurses at the Baptist Hospital of Miami developed the patient care facilitator (PCF), a clinical leadership role for nurses within a smaller area of patient responsibility (12-bed hospital), to provide caring professional nursing practice for both patients and s...

Compassion in Practice is a policy introduced in England to develop a culture of compassionate practice among healthcare staff. There is widespread recognition and agreement of the importance of compassionate practice, and the policy offers a vision underpinned by a desirable set of values. In this article, the significance of a coherent vision is explored and is followed by discussion of the n...

Governing boards of healthcare organizations in Canada are accountable for the performance of their organization and provide oversight on their decisions. Traditionally, many healthcare boards have focused on finances and community relations and have deferred responsibility for quality of care to the medical or professional staff. This deferral reflects not only recognition of the expertise of ...

BACKGROUND Co-production is defined as the voluntary or involuntary involvement of users in the design, management, delivery and/or evaluation of services. Interest in co-production as an intervention for improving healthcare quality is increasing. In the acute healthcare context, co-production is promoted as harnessing the knowledge of patients, carers and staff to make changes about which the...

BACKGROUND The current profile of residents living in Canadian nursing homes includes elder persons with complex physical and social needs. High resident acuity can result in increased staff workload and decreased quality of work life. AIMS Safer Care for Older Persons [in residential] Environments is a two year (2010 to 2012) proof-of-principle pilot study conducted in seven nursing homes in...

BACKGROUND Little is known about how hospital organizational and cultural factors associated with implementation of quality initiatives such as the Institute for Healthcare Improvement's (IHI) 100,000 Lives Campaign differ among levels of healthcare staff. DESIGN Evaluation of a mixed qualitative and quantitative methodology ("trilogic evaluation model"). SETTING Six hospitals that joined t...