The Role of Quality Assurance Programs as a Strategy for Improving Quality in Israel's Health Funds
By Revital Gross
Myers-JDC-Brookdale Institute and Bar-Ilan University
Yael Ashkenazi
Myers-JDC-Brookdale Institute
Hava Tabenkin
Haemek Hospital and Clalit Health Services
Avi Porat
Ben Gurion University and Clalit Health Services
Alec Aviram
National Institute for Health Service and Health Policy Research
The improvement of health care processes and outcomes constitutes a major issue on the agenda of health care organizations in Israel and world wide. This trend is related to the rising costs of service provision and the growing demand by clients for quality services. Various organizations supplying health services have adopted improvement approaches which were developed in industry, focusing mainly on improving processes and measuring outcomes, rather than on looking for those responsible for failures.
Quality Assurance programs are on-going structured programs that include a "quality cycle" of data collection and analysis to identify problems, constructing and implementing interventions, and repeated data gathering to assess the effect of the intervention and modify it where necessary. Such programs may improve quality as well as prevent waste, but studies have shown that it is not always easy to inculcate them into organizations and to preserve them over time. The goal of the study presented here was to examine the quality improvement activities carried out in the community by Israel's four health funds. Using qualitative methods, we examined the types of improvement activities, the role that quality assurance programs play in the context of these activities and the areas in which there is a need for additional programs.
The findings reveal that the health funds express commitment to quality improvement, and take action to promote it. A major finding is that Quality Assurance programs are not the main strategy in the improvement efforts. The discussion examines possible explanations for this as well as ways to encourage quality activities in the health funds.