Individual and Organizational Conditions Leading to Quality of Care in Healthcare: A Fuzzy-Set Qualitative Comparative Analysis

Abstract

Quality of care is a complex performance measure of healthcare performance that considers the influence of several contributors. This study enlarges our understanding of how such influences occur. We analyze individual and organizational level characteristics that have a complex relationship with quality of care. We examine specific patterns that lead to both the presence and absence of quality of care using a fuzzy-set qualitative comparative analysis. Our data comes from an online survey of healthcare professionals from a Portuguese university hospital, namely nursing and medical professionals. Our results reveal that combinations of individual-level characteristics, such as the quality of social support among professional peers and the perceived robustness of social networks, contribute to perceptions of quality of care. In addition, the results indicate that combinations of organizational-level characteristics, such as the presence of ethical leadership and the awareness of knowledge management systems, also lead to perceptions of quality of care. The solutions leading to the presence and absence of quality of care are discussed. We conclude that managerial practices in the university hospital should foster informal communication and peer support, given how pervasive their influence is on quality of care, even in circumstances where ethical leadership and awareness of knowledge management systems are absent from the configurations. Additionally, we reveal combinations of both individual-level and organizational-level characteristics that generate the absence of such quality of care, and thus we alert managers for the need to fight such situations.