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How teams use indicators for quality improvement – A multiple-case study on the use of multiple indicators in multidisciplinary breast cancer teams


  • Gort, Marjan
  • Broekhuis, Manda
  • Regts, Gerdien


A crucial issue in healthcare is how multidisciplinary teams can use indicators for quality improvement. Such teams have increasingly become the core component in both care delivery and in many quality improvement methods. This study aims to investigate the relationships between (1) team factors and the way multidisciplinary teams use indicators for quality improvement, and (2) both team and process factors and the intended results. An in-depth, multiple-case study was conducted in the Netherlands in 2008 involving four breast cancer teams using six structure, process and outcome indicators. The results indicated that the process of using indicators involves several stages and activities. Two teams applied a more intensive, active and interactive approach as they passed through these stages. These teams were perceived to have achieved good results through indicator use compared to the other two teams who applied a simple control approach. All teams experienced some difficulty in integrating the new formal control structure, i.e. measuring and managing performance, in their operational task, and in using their ‘new’ managerial task to decide as a team what and how to improve. Our findings indicate the presence of a network of relationships between team factors, the controllability and actionability of indicators, the indicator-use process, and the intended results.

Suggested Citation

  • Gort, Marjan & Broekhuis, Manda & Regts, Gerdien, 2013. "How teams use indicators for quality improvement – A multiple-case study on the use of multiple indicators in multidisciplinary breast cancer teams," Social Science & Medicine, Elsevier, vol. 96(C), pages 69-77.
  • Handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:69-77
    DOI: 10.1016/j.socscimed.2013.06.001

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    References listed on IDEAS

    1. Patrick W. Leung & Ken T. Trotman, 2008. "Effect of different types of feedback on the level of auditors’ configural information processing," Accounting and Finance, Accounting and Finance Association of Australia and New Zealand, vol. 48(2), pages 301-318, June.
    2. de Vos, M.L.G. & Graafmans, W.C. & Kooistra, M. & Meijboom, B.R. & van der Voort, P.H. & Westert, G.P., 2009. "Using quality indicators to improve hospital care : A review of the literature," Other publications TiSEM 5f462bc9-0ac0-47f7-8f97-7, Tilburg University, School of Economics and Management.
    3. Renae A. Jones & Nerina L. Jimmieson & Andrew Griffiths, 2005. "The Impact of Organizational Culture and Reshaping Capabilities on Change Implementation Success: The Mediating Role of Readiness for Change," Journal of Management Studies, Wiley Blackwell, vol. 42(2), pages 361-386, March.
    4. Meltzer, David & Chung, Jeanette & Khalili, Parham & Marlow, Elizabeth & Arora, Vineet & Schumock, Glen & Burt, Ron, 2010. "Exploring the use of social network methods in designing healthcare quality improvement teams," Social Science & Medicine, Elsevier, vol. 71(6), pages 1119-1130, September.
    5. van der Geer, Eric & van Tuijl, Harrie F.J.M. & Rutte, Christel G., 2009. "Performance management in healthcare: Performance indicator development, task uncertainty, and types of performance indicators," Social Science & Medicine, Elsevier, vol. 69(10), pages 1523-1530, November.
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