Planning and Studying Improvement in Patient Care: The Use of Theoretical Perspectives
Milbank QuarterlyPublished 22 February 2007
Richard Grol, Marije Bosch, Marlies Hulscher, Martin Eccles, Michel Wensing
Citations977
SJR quartileQ1
SJR score2.75
SNIP2.03
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
It is demonstrated how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality-improvement strategies.
Abstract
A consistent finding in articles on quality improvement in health care is that change is difficult to achieve. According to the research literature, the majority of interventions are targeted at health care professionals. But success in achieving change may be influenced by factors other than those relating to individual professionals, and theories may help explain whether change is possible. This article argues for a more systematic use of theories in planning and evaluating quality-improvement interventions in clinical practice. It demonstrates how different theories can be used to generate testable hypotheses regarding factors that influence the implementation of change, and it shows how different theoretical assumptions lead to different quality-improvement strategies.
Keywords
Health Professions
Organizational Behavior and Human Decision ProcessesThe theory of planned behavior
84,784 Citations1991Icek Ajzen
Macat Library eBooksA Theory of Cognitive Dissonance
18,338 Citations2017Léon Festinger, Alexander O’Connor
Revista Española de Investigaciones SociológicasOrganizational Learning: A Theory of Action Perspective
11,145 Citations1997Ch. Argyris, Donald A. Schön
Academy of Management ReviewOrganizational Culture and Leadership
9,693 Citations1986William G. Tierney, Edgar H. Schein
American Journal of Health PromotionThe Transtheoretical Model of Health Behavior Change
7,785 Citations1997James O. Prochaska, Wayne F. Velicer
If results with stage-matched interventions continue to be replicated, health promotion programs will be able to produce unprecedented impacts on entire at-risk populations.
Advances in experimental social psychologyThe Elaboration Likelihood Model of Persuasion
7,565 Citations1986Richard E. Petty, John T. Cacioppo
This chapter discusses a wide variety of variables that proved instrumental in affecting the elaboration likelihood, and thus the route to persuasion, and outlines the two basic routes to persuasion.
Handbooks of sociology and social researchHandbook of Social Psychology
7,552 Citations2013John DeLamater, Amanda K. Ward
Milbank QuarterlyDiffusion of Innovations in Service Organizations: Systematic Review and Recommendations
7,519 Citations2004Trisha Greenhalgh, Glenn Robert +3 more
A parsimonious and evidence-based model for considering the diffusion of innovations in health service organizations, clear knowledge gaps where further research should be focused, and a robust and transferable methodology for systematically reviewing health service policy and management are discussed.
Journal of Marketing ResearchThe Psychology of Attitudes
7,190 Citations1997Dipankar Chakravarti, Alice H. Eagly +1 more
Academy of Management JournalORGANIZATIONAL INNOVATION: A META-ANALYSIS OF EFFECTS OF DETERMINANTS AND MODERATORS.
6,409 Citations1991Fariborz Damanpour
Choice Reviews OnlineHandbook of social psychology
4,710 Citations2004
This book discusses the development of socialization in Childhood and Adolescence, socialization for Primary, Intimate, and Work Relationships in the Adult Life Course, and cross-Cultural and International Perspectives.
The LancetFrom best evidence to best practice: effective implementation of change in patients' care
4,473 Citations2003Richard Grol, Jeremy Grimshaw
BMJ Quality & SafetyMaking psychological theory useful for implementing evidence based practice: a consensus approach
3,607 Citations2005Susan Michie
A set of behaviour change domains agreed by a consensus of experts is available for use in implementation research and applications of this domain list will enhance understanding of the behaviour change processes inherent in implementation of evidence-based practice.
Health Technology AssessmentEffectiveness and efficiency of guideline dissemination and implementation strategies
3,054 Citations2004Jeremy Grimshaw, Ruth Thomas +11 more
A systematic review of the effectiveness and costs of different guideline development, dissemination, and implementation strategies was taken and a framework for deciding when it is efficient to develop and introduce clinical guidelines was developed.
Journal of Applied PsychologyTask versus relationship conflict, team performance, and team member satisfaction: A meta-analysis.
3,020 Citations2003Carsten K. W. De Dreu, Laurie R. Weingart
Results revealed strong and negative correlations between relationship conflict, team performance, and team member satisfaction, in contrast to what has been suggested in both academic research and introductory textbooks.
Evaluation: A Systematic Approach
2,952 Citations1979Peter H. Rossi, Mark W. Lipsey +1 more
Milbank QuarterlyOrganizing Care for Patients with Chronic Illness
2,900 Citations1996Edward H. Wagner, Brian T. Austin +1 more
The challenge is to organize these components into an integrated system of chronic illness care, which can be done most efficiently and effectively in primary care practice rather than requiring specialized systems of care.
Management ScienceInformation Technology Implementation Research: A Technological Diffusion Approach
2,747 Citations1990Randolph B. Cooper, Robert W. Zmud
Using a random sample of manufacturing firms across the United States, it is found that this interaction of managerial tasks with the information technology does indeed affect the adoption of MRP, though it does not seem to affect MRP infusion.
Annual Review of PsychologyATTITUDES AND ATTITUDE CHANGE
2,259 Citations1997Richard E. Petty, Duane T. Wegener +1 more
Empirical and conceptual developments over the past four years on attitudes and persuasion are reviewed, with particular attention paid to work on attitude accessibility, ambivalence, and the affective versus cognitive bases of attitudes.
BMJ Quality & SafetyEnabling the implementation of evidence based practice: a conceptual framework.
2,045 Citations1998Alison Kitson, Gill Harvey +1 more
The paper offers a conceptual framework that considers this imbalance, showing how it might work in clarifying some of the theoretical positions and as a checklist for staff to assess what they need to do to successfully implement research into practice.
New England Journal of MedicineContinuous Improvement as an Ideal in Health Care
1,725 Citations1989Donald M. Berwick
Imagine two assembly lines, monitored by two foremen, one of whom has the means to measure the work, and the other who watches, and finds those among you who are unprepared or unwilling to do their jobs.
Academic MedicineThe psychological basis of problem-based learning
1,475 Citations1992G R Norman, Henk G. Schmidt
There is no evidence that PBL curricula result in any improvement in general, content-free problem-solving skills, and there are several potential advantages for students' learning claimed for problem-based learning.
Annals of Internal MedicineSystematic Review: The Relationship between Clinical Experience and Quality of Health Care
1,474 Citations2005Niteesh K. Choudhry, Robert H. Fletcher +1 more
The robustness of the relationship between clinical experience and quality of care is assessed by systematically reviewing empirical studies to assess the effects of experience on the quality of medical care.
Journal of Management StudiesORGANIZATIONAL INNOVATION: REVIEW, CRITIQUE AND SUGGESTED RESEARCH DIRECTIONS*
1,418 Citations1994Richard Wolfe
The Medical Journal of AustraliaWhat drives change? Barriers to and incentives for achieving evidence‐based practice
1,411 Citations2004Richard Grol, Michel Wensing
To bridge the gap between scientific evidence and patient care the authors need an in‐depth understanding of the barriers and incentives to achieving change in practice, and potential barriers at various levels need to be addressed.
Patient Education and CounselingHealth promotion planning: An educational and environmental approach
1,395 Citations1992Sally L. Lusk
Milbank QuarterlyImproving the Quality of Health Care in the United Kingdom and the United States: A Framework for Change
1,357 Citations2001Ewan Ferlı́e, Stephen M. Shortell
The multilevel change framework and associated properties provide a framework for assessing progress along the journey in efforts to sustain the impetus for quality improvement over time.
Administrative Science QuarterlyInnovation and Creativity at Work: Psychological and Organizational Strategies.
1,345 Citations1992Dean Keith Simonton, Michael West +1 more
Health Promotion Planning: An Educational and Environmental Approach
1,292 Citations1991Lawrence W. Green, Marshall W. Kreuter
This second edition of this book is expanded to incorporate health promotion which the authors define as ‘... the combination of educational and environmental supports for actions and conditions of living conducive to health’.
Journal of Business ResearchOrganizational innovation adoption: a multi-level framework of determinants and opportunities for future research
1,245 Citations2002R.T. Frambach, Niels Schillewaert
PubMedTranslating guidelines into practice. A systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines.
1,227 Citations1997Dave A. Davis, Anne Taylor‐Vaisey
The evidence shows serious deficiencies in the adoption of CPGs in practice and future implementation strategies must overcome this failure through an understanding of the forces and variables influencing practice and through the use of methods that are practice- and community-based rather than didactic.
Cochrane Database of Systematic ReviewsLocal opinion leaders: effects on professional practice and health care outcomes
1,086 Citations2011Gerd Flodgren, Elena Parmelli +5 more
Opinion leaders alone or in combination with other interventions may successfully promote evidence-based practice, but effectiveness varies both within and between studies.
BMJThe role of patient care teams in chronic disease management
1,045 Citations2000Edward H. Wagner
A Medline search for randomised controlled trials of team care using the MeSH heading “patient care team” considered the implications of these observations for the structure and functioning of patient care teams in primary care.
Social NetworksSocial network thresholds in the diffusion of innovations
1,021 Citations1996Thomas W. Valente
A social network threshold model of the diffusion of innovations based on the Ryan and Gross (1943) adopter categories is created, which uses social networks as a basis for adopter categorization, instead of solely relying on the system-level analysis used previously.
Journal of Clinical EpidemiologyChanging the behavior of healthcare professionals: the use of theory in promoting the uptake of research findings
914 Citations2005Martin Eccles, Jeremy Grimshaw +3 more
This research offers a framework for those who would seek to use the results of research studies in routine healthcare settings to design and conduct interventions aimed at improving the use of research findings by individual healthcare professionals or teams.
BMJAttributes of clinical guidelines that influence use of guidelines in general practice: observational study
888 Citations1998R.P.T.M. Grol, J. Dalhuijsen +4 more
People and organisations setting evidence based clinical practice guidelines should take into account some of the other important attributes of effective recommendations for clinical practice, including evidence based, controversial, concrete.
International Journal of Technology Assessment in Health CareEffectiveness and efficiency of guideline dissemination and implementation strategies
867 Citations2005Jeremy Grimshaw, Ruth Thomas +11 more
Sloan management reviewEmpowering Service Employees
786 Citations1995David E. Bowen, Edward E. Lawler
Psychology and HealthInterventions to change health behaviours: evidence-based or evidence-inspired?
776 Citations2004Susan Michie, Charles Abraham
It is concluded that intervention descriptions are often not specific about the techniques employed and that there is no clear correspondence between theoretical inspiration and adoption of particular change techniques.
International Journal for Quality in Health CareDeterminants of innovation within health care organizations: Literature review and Delphi study
773 Citations2004M.A.H. Fleuren
An overview of determinants of innovations in health care organizations is obtained through a literature review and a Delphi study to achieve consensus among a group of implementation experts on determinants identified from the literature review.
JAMACan Health Care Teams Improve Primary Care Practice?
761 Citations2004Kevin Grumbach
Taking small steps toward team development may improve the work environment in primary care practices and help physicians and nonphysician professionals work together as teams to demonstrate improved patient outcomes.
BMJComplexity, leadership, and management in healthcare organisations
723 Citations2001Paul E. Plsek, Timothy D. Wilson
This article describes applications of complexity thinking in the organisation and management of health care and suggests that relationships between parts are more important than the parts themselves, that minimum specifications yield more creativity than detailed plans.
PubMedAssessing the impact of continuous quality improvement/total quality management: concept versus implementation.
689 Citations1995Stephen M. Shortell, J. L. O'Brien +5 more
A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation and was positively associated with greater perceived patient outcomes and human resource development.
Milbank QuarterlyAssessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress
645 Citations1998Stephen M. Shortell, Charles L. Bennett +1 more
The clinical application of CQI is more likely to have a pervasive impact when it takes place within a supportive regulatory and competitive environment, when it is aligned with financial incentives, and under the direction of an organizational leadership that is committed to integrating all aspects of the work.
International Journal for Quality in Health CareIntegrated care programmes for chronically ill patients: a review of systematic reviews
598 Citations2005Mariëlle Ouwens
Integrated care programmes seemed to have positive effects on the quality of care, however, integrated care programmes have widely varying definitions and components and failure to recognize these variations leads to inappropriate conclusions about the effectiveness of these programmes and to inappropriate application of research results.
Journal of Management StudiesUnderstanding Organizational Learning Capability
569 Citations1996Anthony J. DiBella, Edwin C. Nevis +1 more
BMJ Quality & SafetyImproving Patient Care: The Implementation of Change in Clinical Practice
559 Citations2006Janel Cosby
Improving Patient Care: The Implementation of Change in Clinical Practice
553 Citations2005R. Grol, Michel Wensing +3 more
Medical CareThe Awareness-to-Adherence Model of the Steps to Clinical Guideline Compliance
499 Citations1996Donald E. Pathman, Thomas R. Konrad +3 more
This model may prove useful in identifying ways to improve physicians' adherence to a variety of guidelines by demonstrating where physicians fall off the path to adherence, which physicians are at greatest risk for not attaining each step in the path, and factors associated with a greater likelihood of attainingEach step toward guideline adherence.
JAMAExternal Incentives, Information Technology, and Organized Processes to Improve Health Care Quality for Patients With Chronic Diseases
473 Citations2003Lawrence P. Casalino, Robin R. Gillies +8 more
The use of CMPs varies greatly among POs, but it is low on average, and government and private purchasers of health care may increase CMP use by providing external incentives for improvement of health Care quality to POs and by assisting them in improving their clinical IT capability.
International Journal for Quality in Health CareImplementing culture change in health care: theory and practice
409 Citations2003Tim Scott
To transform the culture of a whole health system such as the UK National Health Service would be a complex, multi-level, and uncertain process, comprising a range of interlocking strategies and supporting tactics unfolding over a period of years.
British Journal of ManagementExplaining the Diffusion of Knowledge Management: The Role of Fashion
401 Citations2001Harry Scarbrough, Jacky Swan
Implementation ScienceDesigning theoretically-informed implementation interventions
395 Citations2006
The explicit use of theory offers potential advantages in terms of facilitating a better understanding of the generalisability and replicability of implementation interventions, however, this is a relatively unexplored methodological area.
Medical CareThe Role of Perceived Team Effectiveness in Improving Chronic Illness Care
389 Citations2004Stephen M. Shortell, Jill A. Marsteller +6 more
Perceived team effectiveness was consistently associated with both a greater number and depth of changes made to improve chronic illness care and the importance of developing effective teams for improving the quality of care for patients with chronic illness.
International Journal for Quality in Health CareEffects of financial incentives on medical practice: results from a systematic review of the literature and methodological issues
359 Citations2000Carine Chaix-Couturier, Isabelle Durand‐Zaleski +2 more
All financial incentives that had been proposed, described, or used regardless of their initial objective were identified and, when possible, assessed to assess the results of these incentives on costs, process or outcomes of care.
Journal of Hospital InfectionThe epic Project: Developing National Evidence-based Guidelines for Preventing Healthcare associated Infections
355 Citations2001Robert Pratt, Carol Pellowe +14 more
The introduction to these guidelines describes a robust and validated guideline development model that can be used by others to develop future guidelines.
QRB - Quality Review BulletinImplementing Clinical Practice Guidelines: Social Influence Strategies and Practitioner Behavior Change
351 Citations1992Brian S. Mittman, Xenia Tonesk +1 more
A broad range of strategies for implementing clinical practice guidelines based on the social influences that affect health practitioner behavior are described and issues surrounding the selection and use of individual strategies or combinations of strategies in specific efforts to improve the quality of health care are examined.
International Journal of Technology Assessment in Health CareThe State of the Art Versus the State of the Science: The Diffusion of New Medical Technologies into Practice
351 Citations1988Ann Greer
Concepts from organizational literature become useful in explaining the penetration of these medical communities and the circumstances under which a new modality takes hold in them.
Health Education ResearchSelf-efficacy in health promotion research and practice: conceptualization and measurement
339 Citations1995Edward Maibach, Debra A. Murphy
Journal of Health Services Research & PolicyDoes organisational culture influence health care performance? A review of the evidence
328 Citations2003Tim Scott, Russell Mannion +2 more
There is some evidence to suggest that organisational culture may be a relevant factor in health care performance, yet articulating the nature of that relationship proves difficult and simple relationships such as 'strong culture leads to good performance' are not supported by this review.
American Journal of Critical CareThe Link Between Teamwork and Patients’ Outcomes in Intensive Care Units
326 Citations2003Susan A. Wheelan, Christian N. Burchill +1 more
The evidence is sufficient to warrant the implementation of strategies designed to improve the level of teamwork and collaboration among staff members in intensive care units.
Medical CareEvaluating the Message: The Relationship Between Compliance Rate and the Subject of a Practice Guideline
324 Citations1994Roberto Grilli, Jonathan Lomas
The target area of practice and the complexity and trialability of the recommended procedure appear to be useful, if partial, predictors of the level of compliance with a practice guideline.
The Joint Commission Journal on Quality ImprovementA Framework for the Continual Improvement of Health Care: Building and Applying Professional and Improvement Knowledge to Test Changes in Daily Work
306 Citations1993Paul B. Batalden, Patricia K. Stoltz
A framework is presented that defines the new body of knowledge which, when joined with the professional knowledge of health care workers, can make continual improvement possible; and requirements for building and applying this knowledge to bring about improvement in health care organizations are given.
JAMAThe Case for Using Industrial Quality Management Science in Health Care Organizations
304 Citations1989Glenn Laffel
Health care organizations may well make important advances in the quality of care and service through the application of principles and techniques developed in modern industrial quality science.
The LancetImproving the performance of health services: the role of clinical leadership
298 Citations2003Chris Ham
Reform of health-care systems in the past decade has been driven by ideas such as public/private partnerships, managed competition, managed care, and integrated care, but in professional organisations like hospitals and primary-care practices, many effects on decision-making exist, which may result in a gap between policy intent and delivery.
BMJ Quality & SafetyImplementing guidelines in general practice care.
289 Citations1992Richard Grol
The current views and research on implementing guidelines are explored and some recommendations on methods and approaches to quality improvement in general practice are suggested.
Medical CareAssessing the Impact of Total Quality Management and Organizational Culture on Multiple Outcomes of Care for Coronary Artery Bypass Graft Surgery Patients
283 Citations2000Stephen M. Shortell, Robert H. Jones +7 more
There was little effect of TQM and organizational culture on multiple endpoints of care for CABG patients and there is a need to examine further the relationships among individual professional skills and motivations, group and microsystem team processes, specifically tailored interventions, and organization-wide culture, decision support processes, and incentives.
BMJ Quality & SafetyTeam structure, team climate and the quality of care in primary care: an observational study
273 Citations2003Peter Bower
The study suggests that there are important relationships between team structure, process, and outcome that may be of relevance to quality improvement initiatives in primary care.
BMJ Quality & SafetyA framework for effective management of change in clinical practice: dissemination and implementation of clinical practice guidelines.
252 Citations1999Nicole Moulding, C Silagy +1 more
A conceptual framework for guideline dissemination and implementation is presented which draws on relevant concepts from diffusion of innovation theory, the transtheoretical model of behaviour change, health education theory, social influence theory, and social ecology, as well as evidence from systematic literature reviews on the effectiveness of various behaviour change strategies.
Milbank QuarterlyA Report Card on Continuous Quality Improvement
249 Citations1998David Blumenthal, Charles M. Kilo
Until there is a profound, organization-wide recognition of the need for change, universal commitment to CQI principles will not be achieved.
Implementation ScienceOrganizational interventions to implement improvements in patient care: a structured review of reviews
248 Citations2006Michel Wensing, Hub Wollersheim +1 more
BMJSystematic review of the effectiveness of stage based interventions to promote smoking cessation
247 Citations2003Rob Riemsma, Jill Pattenden +5 more
Overall, the evidence suggests that stage based interventions are no more effective than non-stage based interventions or no intervention in changing smoking behaviour.
BMJContinuing medical education: Learning and change: implications for continuing medical education
243 Citations1998Robert Fox, Nancy L. Bennett
This article describes some of these models and sets out the key principles that have emerged for continuing medical education in the past decade, which have increasingly been accepted that CME programmes are based—or should be—on the principle of teaching and education as a means of facilitating learning.
British Journal of ManagementCritical Aspects of Organizational Learning Research and Proposals for Its Measurement
231 Citations2001Satu Lähteenmäki, Jouko Toivonen +1 more
This paper introduces one set of OL measures developed to study whether organizational learning occurred during the operational and business culture change process of a single case company and suggests for further OL research are made on the basis of experiences gained when empirically testing this model.
Annals of Internal MedicinePhysicians as Leaders in Improving Health Care: A New Series in <i>Annals of Internal Medicine</i>
224 Citations1998Donald M. Berwick, Thomas W. Nolan
To effect a positive outcome for the emerging structure of the authors' health care system, all physicians will increasingly need to replace handwringing with active citizenship and use of their considerable power and influence in the improvement of care.
BMJ Quality & SafetyDesigning a quality improvement intervention: a systematic approach
212 Citations2003Marloes Amantia van Bokhoven
Decisions that have to be made during the design process of a quality improvement intervention are visualised, allowing them to serve as a starting point for a systematic evaluation of the intervention.
The International Journal of Health Planning and ManagementIncentives and provider payment methods
189 Citations1995Howard Barnum, Joseph Kutzin +1 more
It is concluded that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method.
PubMedCharacteristics of effective clinical guidelines for general practice.
189 Citations2003Jako Burgers, Richard Grol +4 more
If the recommendations are not compatible with existing norms and values, not easy to follow or require new knowledge and skills, appropriate implementation strategies should be designed to ensure change in daily practice.
Journal of Clinical EpidemiologyAttributes of clinical recommendations that influence change in practice following audit and feedback
185 Citations2002Robbie Foy, Graeme MacLennan +4 more
An observational study using multilevel modeling to examine the relationship between attributes of clinical practice recommendations and compliance with the recommendations before and after audit and feedback found recommendations seen as incompatible with clinician values are associated with lower compliance but greater behavioral change following audit and Feedback.
British Journal of Health PsychologySalient beliefs and intentions to prescribe antibiotics for patients with a sore throat
182 Citations2001Alison Walker, Jeremy Grimshaw +1 more
Attitudes towards antibiotics and control beliefs are important predictors of intention to prescribe, as predicted by TPB and interventions could target salient beliefs associated with motivation to prescribe.
BMJResearch in medical education: three decades of progress
174 Citations2002Geoffrey R. Norman
How research in medical education has contributed substantially to understanding the learning process is a personal reflection on how this research has informed the authors' understanding of learning, teaching, and assessment in medicine.
TechnovationManaging knowledge transfer by knowledge technologies
170 Citations2002Achille Claudio Garavelli, Michele Gorgoglione +1 more
It is argued that, to define the properties of a KT, it is necessary to analyze the cognitive context in which knowledge transfer takes place, and a cognitive approach for knowledge transfer analysis is proposed.
Annals of Internal MedicineCooperation: The Foundation of Improvement
158 Citations1998Terry P. Clemmer, Vicki J. Spuhler +2 more
A review of modern theories of the foundations, uses, and problems of cooperation is beyond the scope of this paper, but a few examples suggest the richness of the scientific terrain for potential students of the topic.
The Cochrane Database of Systematic ReviewsLocal opinion leaders: effects on professional practice and health care outcomes
157 Citations1999MA O'Brien, AD Oxman +4 more
Using local opinion leaders results in mixed effects on professional practice; however, it is not always clear what local opinion Leaders do and replicable descriptions are needed.
Preventive MedicinePromoting health and preventing disease in health care settings: An analysis of barriers
148 Citations1987Mario Orlandi
The opportunities for health promotion and disease prevention in health care settings are reviewed and a range of barriers to such efforts are identified within a framework that focuses on dissemination and implementation as critical steps in the knowledge transfer process.
JAMAEffect of a Clinical Practice Improvement Intervention on Chlamydial Screening Among Adolescent Girls
143 Citations2002Mary–Ann Shafer
Implementation of this clinical practice improvement intervention in a large health maintenance organization system is feasible, and it significantly increased the C trachomatis screening rates for sexually active adolescent girls during routine checkups.
PubMedThe case for using industrial quality management science in health care organizations.
142 Citations1989Glenn Laffel, David Blumenthal
Archives of Internal MedicineThe Effect of Explicit Financial Incentives on Physician Behavior
141 Citations2001Brian S. Armour, M. Melinda Pitts +5 more
The literature review revealed a paucity of data on the effect of explicit financial incentives, and the empirical evidence regarding the effectiveness of bonus payments on physician resource use and the quality of patient care is mixed.
Health Education ResearchPlanned health education and the role of self-efficacy: Dutch research
135 Citations1991Gerjo Kok, Hein de Vries +2 more
…