Improving Quality of Care Through Integration in a Hospital Setting: A Human Systems Integration Approach

Abstract—While many studies suggest that integration is positively
associated with improved quality of care, others assert that
this may not be so. The inconsistent success of integration to improve
performance is not limited to healthcare operations, but is
prevalent in operations and engineering management in general.
We suggest that this inconsistency exists because many integration
studies examine technical components of integration, but not human
components of integration.We use recent works on the theory
of human systems integration to explain how the technical components
of a system, examined through formal integrative practices
and informal integrative practices, and the human components of
a system, examined through belief in integration and understanding
of integration, interact to influence quality of care. In a study
of 34 hospital departments, we found strong support for the interaction
between the technical and human components, such that
formal integrative practices are associated with higher quality of
care when understanding of integration is high rather than low as
we theoretically suggest.Unexpectedly, our results also suggest that
not all integration practices influence quality of care; we discuss
the implications of these findings for practice and future research
applications.
(Index Terms—Healthcare, human systems integration (HSI
integration, management of quality, organizational culture,