How Hospitals Choose a Quality Management System: Relevant Criteria in Large Spanish Hospitals

Abstract

This article examines the selection criteria used by hospital managers when choosing a quality management system (QMS): ISO 9001, Joint Commission (JC), EFQM, or a combination of them. Furthermore, this study provides a view of how extensive is the use of QMS in the main Spanish hospitals. Between December 2004 and March 2005, a questionnaire was sent to Spanish hospitals of size > 400 beds. Of the 101 hospitals that met the conditions of research, 42 responded to the survey: a response index of 41.58% (95% reliability and maximum margin of error of 11.6%). We have deduced the selection criteria from a contents analysis of the three models. We have confirmed two hypotheses: first, that there are 16 relevant selection criteria for hospitals when deciding on a QMS; and secondly, that they choose QMS on the basis of the priority they attribute to given selection criteria. The data lead us to the following conclusion: implementation of QMS in Spanish hospitals is quite extensive: 71.4% use ISO 9001; 11.9% JC, and 69% EFQM. The combined use of ISO 9001 and EFQM (47.6%) has also been noted. 15 of 16 criteria have been shown to be relevant, and no new criteria have been discovered.

Keywords:

• Quality management system
• health care
• excellence models
• quality evaluation
• accreditation
• ISO 9000
• EFQM
• joint commission

Acknowledgements

This research was financed by the Volkswagen Navarra Chair of Quality and by the Navarre Foundation for Quality.