The Impact of Healthcare Delivery Complexity on Practices for Clinical Quality Improvement: A Case of Healthcare Workers’ Hand Hygiene Compliance

Wenlin Chen (), Chung-Li Tseng () and Cynthia Tseng ()
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Wenlin Chen: School of Management and Economics, University of Electronic Science and Technology of China, Chengdu 610054, China
Chung-Li Tseng: University of New South Wales School of Business, University of New South Wales, Sydney, New South Wales 2052, Australia
Cynthia Tseng: Research and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland 20723

Service Science, 2023, vol. 15, issue 4, 283-301

Abstract: Healthcare providers often implement quality improvement (QI) practices to improve clinical quality, which may be measured as the extent to which healthcare workers (HCWs) comply with standardized procedures designed for ensuring patient safety. Unfortunately, the effectiveness of QI practices to improve clinical quality varies from facility to facility because of healthcare delivery complexity. In this paper, we consider the contextual complexity and the provider complexity arising from healthcare delivery processes, and we propose an exploratory study based on discrete choice experiments to examine their roles in the relationship between QI practices and clinical quality. By collecting and analyzing data from 320 HCWs at a university hospital in Taiwan, we found that healthcare delivery complexity significantly moderated the effectiveness of QI practices and how they improved clinical quality. We found that the contextual complexity influenced the level of effectiveness of the QI practices, whereas the provider complexity influenced whether a QI practice may be effective or not. We also studied the effect of implementing multiple QI practices simultaneously to counter the provider complexity. We found that implementing more QI practices does not necessarily lead to better outcomes, but implementing the right ones would. Our findings provide healthcare facilities with ex ante insights for designing QI practices to improve clinical quality.

Keywords: clinical quality; quality improvement practices; healthcare delivery complexity; hand hygiene; discrete choice experiment (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:inm:orserv:v:15:y:2023:i:4:p:283-301

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