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PSNet: Patient Safety Network
Journal Article

Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies.

Vaughn VM, Saint S, Krein SL, et al. BMJ quality & safety. 2019;28:74-84.

The literature on effective approaches to improving quality and safety generally focuses on high reliability organizations and positive deviants—organizations or units that have achieved notable successes. This systematic review sought to characterize organizations that struggle to improve quality. The authors identified five domains that exemplify struggling organizations, including lack of a clear mission and organizational structure for improving quality and inadequate infrastructure.