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Journal cover: International Journal of Health Care Quality Assurance

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Online from: 1988

Subject Area: Health Care Management/Healthcare

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Implementing QA programs in managed care health plans: factors contributing to success


Document Information:
Title:Implementing QA programs in managed care health plans: factors contributing to success
Author(s):Revital Gross, (Myers-JDC-Brookdale Institute, and Bar Ilan Univeristy, Jerusalem, Israel), Yael Ashkenazi, (Myers-JDC-Brookdale Institute, Jerusalem, Israel), Hava Tabenkin, (Haemeq Hospital, Afula, Israel and Clalit Health Services, Tel Aviv, Israel), Avi Porath, (Ben-Gurion University of the Negev, Be'er Sheva, Israel and Clalit Health Services, Tel Aviv, Israel), Alec Aviram, (National Institute for Health Policy and Health Services Research, Tel Hashomer, Israel)
Citation:Revital Gross, Yael Ashkenazi, Hava Tabenkin, Avi Porath, Alec Aviram, (2008) "Implementing QA programs in managed care health plans: factors contributing to success", International Journal of Health Care Quality Assurance, Vol. 21 Iss: 3, pp.308 - 324
Keywords:Health services, Israel, Medical management, Quality assurance
Article type:Research paper
DOI:10.1108/09526860810868247 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:The study was funded with the assistance of the National Institute for Health Policy and Health Services Research. The authors would like to thank to members of the study's steering committee for their valuable comments: Dr Yitzchak Alsheikh, Dr Margalit Goldfrecht, Dr Anthony Heymann, Gila Saadia, Yehudit Tzameret, and Professor Eli Kitai. They would also like to thank all the interviewees for their time and Ronit Matzliach who helped conduct the interviews.
Abstract:

Purpose – The purpose of this paper is to identify the factors that contribute to the success or failure of quality assurance programs implemented by Israeli managed care health plans.

Design/methodology/approach – An in-depth study of seven quality assurance programs was conducted, comparing successful with unsuccessful ones using the comparative “case study” method. Employing a semi-structured questionnaire, 42 program directors and professionals in the field were interviewed.

Findings – A number of factors associated with the programs' success emerged. Those external to the program included: ongoing management support, resource allocation, information system support and perceived financial benefit for the organization. Internal factors included: leadership, perceived problem's importance, laying the groundwork in the field, involving field staff in planning and implementation and staff motivation.

Originality/value – The study provides insights into ways to encourage the implementation of successful quality assurance programs in the special organizational context of managed care health plans. As the implementation relies heavily on data, one important precondition is the development of computerized information systems to facilitate ongoing data collection. It is also necessary from the planning stage to take into account organizational factors that affect success.



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