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

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.