Udo Nabitz

A two‐level EFQM self‐assessment in an Italian hospital

PURPOSE An assessment of the EFQM excellence model was carried out in Italys Udine Hospital, aimed at evaluating how first and second-level managers perceived their hospital and individual departments. The study objectives also included identifying strengths and areas requiring improvement and stimulating a quality culture. DESIGN/METHODOLOGY/APPROACH Udines S. Maria della Misericordia Hospital is a large specialised unit in North East Italy and similar to many regional hospitals throughout the country. The survey is a single case study of the hospital and its ten clinical departments. A 153-item questionnaire was completed by 201 experienced respondents. FINDINGS Leadership, policy and strategy, partnership and resources were rated highly, whereas people, society and customer results received lower ratings. Several improvement actions were planned, primarily with regard to the results criteria. PRACTICAL IMPLICATIONS A two-level self-assessment was successfully carried out in a hospital, giving insight into the organisations strengths and areas requiring improvement. Through the study, a systemic approach was introduced and quality awareness was heightened. ORIGINALITY/VALUE The findings are useful for other hospitals conducting EFQM self-assessment.

Improving the EFQM model. An empirical study on model development and theory building using concept mapping.

The aim of this study is to identify the elements and to design a structure for the Improved EFQM Model. This task was given to the Model Development Steering Group composed of 17 members from different European organizations. First the literature was reviewed and the different award programmes were analysed. In order to process all the information collected the method concept mapping was used. The result of the concept mapping were 13 distinct clusters, which were in large part a replication of the EFQM criteria but with more emphasis on customer, suppliers and partnership and a cluster measurement system and results. The comparison of the clusters with the international award schemes shows great resemblance concerning customer orientation, policy and strategy, leadership, process management and business results. The comparison with the empirical findings points in the same direction. The design team of the steering group proposes a prototype for the model and an Improved EFQM Model. The Improved EFQM Model Draft 1 has 11 criteria, a strong focus on customer orientation and a new measuring system. The Improved EFQM Model is the result of the first phase of the model development process. In the second phase the model will be tested in various ways. It is known that the results of the testing turned out differently from what was expected. The test phase and the final EFQM Excellence Model will be published later.

Economic evaluation of internet-based interventions for harmful alcohol use alongside a pragmatic randomized controlled trial.

Background Internet interventions with and without therapist support have been found to be effective treatment options for harmful alcohol users. Internet-based therapy (IT) leads to larger and longer-lasting positive effects than Internet-based self-help (IS), but it is also more costly to provide. Objective To evaluate the cost effectiveness and cost utility of Internet-based interventions for harmful use of alcohol through the assessment of the incremental cost effectiveness of IT compared with IS. Methods This study was performed in a substance abuse treatment center in Amsterdam, the Netherlands. We collected data over the years 2008–2009. A total of 136 participants were included, 70 (51%) were female, and mean age was 41.5 (SD 9.83) years. Reported alcohol consumption and Alcohol Use Disorders Identification Test (AUDIT) scores indicated harmful drinking behavior at baseline. We collected self-reported outcome data prospectively at baseline and 6 months after randomization. Cost data were extracted from the treatment center’s cost records, and sex- and age-specific mean productivity cost data for the Netherlands. Results The median incremental cost-effectiveness ratio was estimated at €3683 per additional treatment responder and €14,710 per quality-adjusted life-year (QALY) gained. At a willingness to pay €20,000 for 1 additional QALY, IT had a 60% likelihood of being more cost effective than IS. Sensitivity analyses attested to the robustness of the findings. Conclusions IT offers better value for money than IS and might therefore be considered as a treatment option, either as first-line treatment in a matched-care approach or as a second-line treatment in the context of a stepped-care approach. Trial Registration Netherlands Trial Register NTR-TC1155; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1155 (Archived by WebCite at http://www.webcitation.org/6AqnV4eTU)

Psychosocial work conditions and work stress in an innovating addiction treatment centre. Consequences for the EFQM Excellence Model

In the Job Demand Control Model (JDCM) and the EFQM Excellence Model, psychosocial work conditions are regarded as critical factors for the functioning of the personnel and the organisation. In order to gain insight into the role of work conditions for the development of work strain and well-being, an empirical study was conducted in an innovating addiction treatment centre in Amsterdam, the Netherlands. The Work Stress Monitor on Mental Health (WSMMH) was used as a measure of the JDCM. A cohort of 209 employees of an addiction treatment centre, in which a far-reaching innovation programme was carried out, participated in this study. With the exception of physical demands, job demands, were high, whereas job controls and the organisational supports were low. Seven out of the 18 work condition scales significantly predicted work strain and well-being. Age and educational level were positive related to well-being. Compared with other health care sectors, work in this addiction treatment centre can be characterised as high-demand low-control and thus as a high strain job. Seven important predictors for this undesirable situation were identified. These predictors can be translated into criteria for the EFQM Excellence Model and can be used to enhance the overall quality of addiction treatment services.

An implementation framework for public service charters: Results of a concept mapping study

Abstract Many organizations have introduced service charters to improve service quality and user satisfaction. However, this goal is not always achieved, with the literature showing both implementation successes and failures. In this article, we analyse the organizational enablers for the implementation of service charters using a concept mapping methodology with an integrated Delphi study. Our empirical investigation, with the support of forty-five experts who had worked with public service charters in the Netherlands, has resulted in a framework involving forty-four organizational enablers. It shows that implementing a service charter requires a change management process that addresses both structures/systems and cultural aspects.

A quality framework for addiction treatment programmes: Results of a concept mapping strategy

Ein Qualitatsrahmen fur Suchtbehandlungsangebote: Ergebnisse einer Concept Mapping Strategie Ziel: Empirische Identifikation von Qualitatskriterien, -clusters und -dimensionen fur Programme der Suchtbehandlung. Methode: Drei Interessengruppen (Stakeholders N=90) generierten 667 Ideen, die zu 70 Statements zusammengefasst und mit mulitivariaten statistischen Techniken analysiert wurden. Ergebnisse: Neun Cluster mit zwei Dimensionen »Best Practice« und »Effektivitat« wurden identifiziert. Die drei wichtigsten Qualitatscluster waren »Klientenorientierung«, »Behandlungsangebot« und »Einstellung der Behandler«. Die drei wichtigsten Statements waren: »Effektivitat des Programms«, »respektvolle Interaktion mit dem Patienten« und »leichter Zugang zu den Behandlungsangeboten«. Schlussfolgerungen: Der empirisch abgeleitete Qualitatsrahmen fur Suchtbehandlungsangebote ist spezifisch und umfassend. Es zeigen sich Ubereinstimmungen und Erganzungen zu bestehenden Zertifizierungs- und Qualitatssiche...

Helpful Factors in the Treatment of Depression from the Patient's, Carer's and Professional's Perspective: A Concept Map Study.

Objective Depression research has resulted in knowledge about neurobiology, pharmacological strategies and short-term cost-effective treatments. However, more than two-thirds of all depressed patients experience insufficient improvement. Therefore, a better understanding of what patients, carers and professionals perceive as most helpful in the treatment of depression is needed. Methods Concept mapping, a mixed-method design, was used to identify the patients (n = 33), carers (n = 22) and professionals (n = 50) perspectives. In six brainstorm sessions, the patients, carers and professionals generated 795 ideas, which were condensed into 55 unique statements. Subsequently, 100 participants prioritized and sorted these statements, which were analysed by multidimensional scaling and cluster analysis and visualized as a two-dimensional map. Results The 55 statements were clustered in 10 factors and further grouped into four main-factors (meta-clusters): ‘Professional therapist’, ‘Treatment content’, ‘Structured treatment process’ and ‘Treatment organisation’. Patients and carers prioritized ‘Treatment organisation’ higher than professionals, but overall there was considerable agreement about the factors of treatment the participants perceived as most helpful including factors related to the therapeutic relationship and the ‘creation of hope’. Conclusions Our study identified factors of depression treatment perceived as helpful according to patients, carers and professionals. Findings suggest that in a scientific era with emphasis on biological psychiatry, not only patients and carers, but also professionals consider aspecific factors the most helpful. Further studies might show that factors we found to be helpful in the treatment for depression, can be generalized to mental health treatment in general.

EFQM Qualitätsmanagement: Einzelfallstudie in einer Beratungsstelle

Fragestellung: Ist der Ansatz der European Foundation for Quality Management (EFQM) geeignet um das Qualitatsniveau einer Suchtberatungsstelle zu verbessern? Methodik: In einer Einzelfallst...