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RESEARCH PRODUCT

Using System Dynamics and Group Model Building to conceptualise Quality of Hospital Services

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Despite the well-established Donabedian model of hospital quality and the notion that Performance Measurement (PM) leads to improved quality of healthcare services (Donabedian, 1988; 2005), a growing part of literature during the last two decades has started doubting those favourable outcomes of PM on quality (De Vos, et al., 2009; Nolan & Berwick, 2006; Werner et al., 2008a, 2008b; Werner & Bradlow, 2006; Wright & Hershman, 2014). The purpose of this research study is to build a more comprehensive conceptual model of hospital quality, able to encompass the feedback mechanisms between elements that the Donabedian model fails to capture. More specifically, we empirically established a qualitative system dynamics model (Causal Loop Diagram) of hospital quality as perceived by participant stakeholders in Group Model Building sessions (Andersen & Richardson, 1997; Vennix, 1996) and used it to explain the dynamic impact of Donabedian measures on quality indicators and provide policymakers with new policies to foster hospital service quality.