Learning goals
o Structural challenge
Learning goal: What are the roles and effects of formal structures in quality improvement
efforts?
Sub-questions: What are advantages and dis-advantages of protocols for quality
improvement work? How can we know that a structure is effective in improving quality
work?
o Cultural challenge
Learning goal: rankings and performance measurements
Sub-questions: What do patients thinks about indicators? What do professionals thinks
about indicators?
o Educational challenge
Learning goal: What is the effect of including relevant stakeholders in incident investigation
on organizational learning?
Sub-questions: Effects of patient participation on organizational learning positive or
negative? Effects of family/friends participation on organizational learning positive or
negative? What role does experiential knowledge (ervaringskennis) of patients/relatives play
in incident investigation?
o Political challenge
Learning goal: how are nurses involved in making and implementing health policy during
crisis situations?
Sub-questions (depending on the article from what perspective you can answer the question)
How do nurses want to be involved? How should nurses be involved? (Perspective of
managers/physicians/nurses)
o Technological challenge
Learning goal: How does the use of AI in healthcare affect it’s quality and safety
Sub questions: What are the ethical limitations of AI in quality and safety? What are the
suitable healthcare setting where we can use AI to improve Q & S? Advantages and
disadvantages of AI in healthcare settings?
o Emotional challenge
Learning goal: What is the influence of emotions of healthcare professionals on quality and
safety?
Sub questions: How does emotional stigmatization of healthcare professionals and patients
influence Q&S in healthcare? How organizations actively involve emotions?
Structural challenge
Article Bate:
This article talks about the challenge which need to be solved in order to successfully improve quality
and safety. Each challenge has different colours, which will create different frameworks between
organisations.
Main point of the article: look at the processes, which colours are important; try to get in all
in the model, however also not too much details.
If you’re doing quality improvement you need to make sure you solve all challenges
Article Bromley and Powell
Important concepts from this study is decoupling. You have 2 different types:
Policy – practice gap (symbolic adoption) – classical approach to decoupling The
organisations says they implemented policies, but in practice there isn’t much going on.
So the policy strategy doesn’t really fit into practice (work-arounds)