Measures to strengthen leadership for quality in the healthcare sector
Governance and leadership are crucial for the quality of medical services. The Federal Council has commissioned the BFH to draw up practical recommendations for strengthening managers in the healthcare system.
Factsheet
- Schools involved School of Health Professions
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Institute(s)
Nursing
Academic-Practice-Partnership Insel Gruppe/ BFH
Kompetenzzentrum Interprofessionalität - Research unit(s) Innovation in the Field of Health Care and Human Resources Development
- Funding organisation Others
- Duration 01.06.2024 - 31.03.2025
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Head of project
Fabienne Josefine Renggli
Dr. Silvia Thomann
Prof. Dr. Christoph Golz -
Project staff
Tanja Siegenthaler
Prof. Dr. Mirjam Körner
Prof. Dr. Kai-Uwe Schmitt
Situation
For more than ten years, it has been pointed out internationally that governance and leadership are important elements in promoting the quality of medical services and thus reducing patient suffering and costs. Within the framework of the national quality strategy for the years 2022-2024, the Federal Council has defined governance as a central field of action. To this end, the Berner Fachhochschule (BFH) was commissioned by the Swiss Federal Quality Commission (EQC) to formulate evidence-based and practice-oriented recommendations for measures to strengthen the leadership of managers at various levels of the healthcare system in order to promote the quality of medical services.
Course of action
In a first step, a literature review will be conducted to summarize the scientific evidence on measures to strengthen the leadership of employees with leadership and management responsibilities for quality. The results will then be reviewed by members of the Advisory Board and discussed in a workshop as part of a Delphi survey. Based on the results of the literature review, a Delphi consensus process will be designed. The identified measures to strengthen leadership for quality in health care will be integrated into an online questionnaire and evaluated live by a group of experts. Finally, the results of the literature review and the expert survey will be reported in terms of evidence-based measures to strengthen leadership for quality in health care and recommendations will be derived for the various stakeholders - providers, insurers and authorities.
Result
The literature analysis included 32 publications and 27 national and international guidelines and standards. From these sources, 67 recommendations were derived to strengthen leadership among providers, insurers, and authorities. These were structured into eight thematic areas: leadership personnel, working conditions, participation, monitoring, communication and culture, evidence- and best-practice-based approaches, inter- and transdisciplinarity, and incentive systems. Of these, 45 recommendations were assessed as relevant and feasible. The most pertinent recommendations are as follows: At the level of public authorities, financing structures should be reviewed and, where necessary, adjusted to meet changing demands in quality assurance and improvement. Healthcare leaders and those with governance responsibilities should ensure transparent and standardized recruitment processes, placing emphasis not only on clinical expertise but also on leadership skills. Quality improvement measures should be defined in consultation with staff, patients, and relatives, and applied in a consistent way. A culture of error management must be fostered, encouraging open discussion of mistakes—including by leaders themselves. Finally, monitoring data should be actively used to guide data-driven quality improvement.
Looking ahead
The most urgent need for action lies in the evaluation and adaptation of existing financing structures with regard to quality assurance and improvement at the level of authorities. This constitutes a fundamental prerequisite for the effective implementation of further measures. The majority of recommendations deemed relevant concern the level of healthcare providers. No recommendations were identified as both relevant and feasible at the level of insurers, nor were additional ones suggested by the experts. The absence of representatives from authorities and insurers at the workshop limited the integration of their perspectives into the development of further practice-oriented recommendations. In particular, evidence from other countries is only partially transferable to the level of insurers due to differing contextual conditions and scopes of influence.
