Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective

André de Waal; Esther Mollema; Eunice Willemstein; Ineke Slagter; Marco Schreurs; Michel Hodes; Peter Boudewijn

doi:10.29333/ajqr/17162

André de Waal ¹ ^* , Esther Mollema ², Eunice Willemstein ³, Ineke Slagter ⁴, Marco Schreurs ², Michel Hodes ⁵, Peter Boudewijn ⁶

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AM J QUALITATIVE RES, Volume 9, Issue 4, pp. 1-33

https://doi.org/10.29333/ajqr/17162

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Abstract

Quality improvement of healthcare institutions has become increasingly important these past decades, mainly due to demographic developments. At the same time, the sector is suffering from political and budgetary pressures which makes quality improvement a tall order. As a result, healthcare institutions have been searching for frameworks which can help them in difficult circumstances to improve their quality by increasing their dynamic capabilities and organizational competencies. This research sets out to identify such a framework. Based on a review of the existing literature the HPO Framework was chosen and subsequently applied at three Dutch nursing home care institutions. In a period of three years the HPO Diagnosis was performed at the three institutions. This yielded information on their status on the way to high performance and attention points which they needed to address to help them further along their journey. Based on an analysis of the transformation process, the experiences and lessons learned from each institution were identified and summarized. All institutions have made progress and achieved better organizational results because of the application of the HPO Framework. The theoretical contribution of this research is that it expands the literature on quality improvement of healthcare institutions based on holistic longitudinal research, and practically it provides healthcare institutions with a validated framework that helps them achieve quality improvements and high performance.

Keywords: Healthcare sector, nursing home care institutes, high performance organizations, longitudinal research, HPO, organizational improvement

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Citation

Waal, A. D., Mollema, E., Willemstein, E., Slagter, I., Schreurs, M., Hodes, M., & Boudewijn, P. (2025). Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective. American Journal of Qualitative Research, 9(4), 1-33. https://doi.org/10.29333/ajqr/17162

Waal, A. D., Mollema, E., Willemstein, E., Slagter, I., Schreurs, M., Hodes, M., and Boudewijn, P. (2025). Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective. American Journal of Qualitative Research, 9(4), pp. 1-33. https://doi.org/10.29333/ajqr/17162

Waal AD, Mollema E, Willemstein E, et al. Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective. AM J QUALITATIVE RES. 2025;9(4), 1-33. https://doi.org/10.29333/ajqr/17162

Waal, André de, Esther Mollema, Eunice Willemstein, Ineke Slagter, Marco Schreurs, Michel Hodes, and Peter Boudewijn. "Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective". American Journal of Qualitative Research 2025 9 no. 4 (2025): 1-33. https://doi.org/10.29333/ajqr/17162

Waal, André de et al. "Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective". American Journal of Qualitative Research, vol. 9, no. 4, 2025, pp. 1-33. https://doi.org/10.29333/ajqr/17162

Waal AD, Mollema E, Willemstein E, Slagter I, Schreurs M, Hodes M, et al. Achieving High Performance in Healthcare Institutions: A Longitudinal Perspective. AM J QUALITATIVE RES. 2025;9(4):1-33. https://doi.org/10.29333/ajqr/17162