Abstract

Abstract Purpose -Developing a performance measure and reporting the results to support decision making at an individual level has yielded poor results in many health systems. The purpose of this paper is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations. Design/methodology/approach -A systematic data collection strategy that includes empirical and theoretical research published from 1980 to 2010, both qualitative and quantitative, was performed on Web of Science, Current Contents, EMBASE and MEDLINE. A narrative synthesis method was used to iteratively detail explicative processes that underlie the intervention. A classification and synthesis framework was developed, drawing on knowledge transfer and exchange (KTE) literature. The sample consisted of 114 articles, including seven systematic or exhaustive reviews. Findings -Results showed that dissemination in itself is not enough to produce improvement initiatives. Successful dissemination depends on various factors, which influence the way collective actors react to performance information such as the clarity of objectives, the relationships between stakeholders, the system's governance and the available incentives. Research limitations/implications -This review was limited to the process of knowledge dissemination in health systems and its utilization by users at the health organization level. Issues related to improvement initiatives deserve more attention. Practical implications -Knowledge dissemination goes beyond better communication and should be considered as carefully as the measurement of performance. Choices pertaining to intervention should be continuously prompted by the concern to support organizational action. Originality/value -While considerable attention was paid to the public reporting of performance information, this review sheds some light on a more promising avenue for changes and improvements, notably in public health systems. Keywords Quality improvement, Performance measurement, Knowledge sharing, Continuous improvement, Decision making, Organization, Knowledge transfer, Health services sector Paper type Literature review The current issue and full text archive of this journal is available at www.emeraldinsight.com/1477-7266.htm The authors would like to thank the Institut de recherche en santé publique de l'Université de Montréal (IRSPUM) and the Agence de santé et de services sociaux de la Montérégie for their funding that made this research possible. They would also like to take this opportunity to thank the reviewers for their comments, which helped improve the manuscript. Introduction In most industrial countries, health systems have committed themselves to implementing reforms in order to resolve dysfunctions and achieve sustainability However, there is strong evidence which suggests that targeting dissemination at the health organization level may gradually lead to desired improvements, since managers and clinicians are more likely to use this information and adopt behaviors that will help improve processes and outcomes (Marshall et al., 2000a, b; The systematic reviews published to date have mainly concentrated on interventions that promote broad dissemination of information and, above all, attempt to examine the impacts on decisions, particularly the decisions of patients or care consumers. None of them are focused exclusively on the dissemination to actors in health organizations, nor on the factors and processes by which interventions lead to the desired effects. As noted by The purpose of this review is to highlight the factors associated with the dissemination of performance information that generate and support continuous improvement in health organizations.