Sara Dahlin: How to strengthen quality improvement in healthcare
Focusing on improved quality of care. The combination of social thinking and engineer thinking is interesting, challenging and exciting,  says Chalmers PhD student Sara Dahlin, who researches how quality in care can be improved.

How to strengthen quality improvement in healthcare

In order to meet the challenges of care, a more comprehensive approach is required. In her research, Sara Dahlin, PhD student at Chalmers, shows how quality improvement can be strengthened by including public procurement and "process mining".
​Sara Dahlins´ research focuses on how quality in care can be improved. She is a PhD student at Chalmers Department of Technology Management and Economics, and now defends her licentiate thesis: Understanding quality improvement in care: The case of public care procurement and process mining
Tell us about your research!
Care has great challenges that quality improvement research tries to support. The objective is to gain a patient-centered care where the resources (time, money, personnel etc.) are used in a sustainable and efficient way. This is not a simple task since care is both complex and dynamic. My research aim is to see how we can understand and support quality improvement in care through looking at related, but mainly unexplored fields for quality improvement in two different ways:
1.    There are areas of care where we do not know how quality improvement is used. I have looked at public procurement of care, which has increased substantially during the last decades, but where there has been little knowledge about how quality improvement is driven.
2.    There are different methodologies used to understand care but these may not be enough to capture the complexity. The process mining methodology may be useful to understand the variation in patient pathways on a more detailed level than what is achieved today. Shortly, process mining is about using documented patient data to create a process map showing the patients´ journey through care, on an individual or group level. This map can also be connected to other patient data to better understand cost, lead times etc.
What are your most important research findings?
Theoretically, the most important conclusion is that quality improvement research field may be better understood and supported by expanding QI application into public care procurement and process mining. This comes primarily from a larger care system´s understanding and understanding of variation, but it also has implications for other parts of quality improvement. The research also identifies variations in quality improvement focus both within and between care procurements. This has managerial implications too. Not only does it show opportunities for increased learning and collaboration, but there is also need for changed ways of working and mindset to gain quality improvement in or through expanded areas. 

“Public procurement of care has increased substantially, but there has been little knowledge about how quality improvement is driven within the area”.

Sara Dahlin, PhD student, Chalmers
What new perspectives do you bring forward in your research?
I have aimed at not inventing the wheel again, rather introduce existing research areas into quality improvement. There has been earlier research on quality improvement, public care procurement and process mining separately before, but I look at the contribution that may come from combining quality improvement with public care procurement and process mining respectively. Primarily, I have looked at how quality improvement is affected, but also its effect on care procurement and process mining – and which pros and challenges this can lead to. These questions have gained very limited focus in earlier quality improvement research.
What can your findings lead to?
My hope is that my research will develop quality improvement research field and that practitioners working with quality improvement will embrace these “new” areas, leading to further learning and understanding of how improvement can be driven. The variation I have found in both public care procurement and through process mining show how much knowledge already exist, but it needs to be exploited or spread. It is not a simple task, but I think that the reward that lies in e.g. increased patient-centeredness and improved use of resources is worth the effort.
Why do you find this area so interesting?
Basically, what motivates me is to contribute to a better care. The important thing is to cope with the quality issues in care in the best possible way and quality improvement mindset has always felt very logical to me. I like the combination of the need to understand every complex situation to fit a solution to it, but also that there are generally successful ways of working and thinking - a smorgasbord from which to pick methods and methodologies appropriate for that situation. That combination of social thinking and engineer thinking is interesting, challenging and exciting.
Text: Ulrika Ernström



Published: Fri 18 Aug 2017. Modified: Wed 10 Oct 2018