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AbstractPublic inquiries are an important phenomenon in modern British society, often used to address controversial or difficult issues of major concern to policy makers, the media and the public. Although people often comment adversely on how costly inquiries are and how long they take, inquiry methods are rarely discussed, let alone critiqued or challenged. However, from a social sciences perspective, inquiry methods, processes and outputs are often at odds with accepted standards for research methods. This paper discusses this divergence and the implications for how we should regard the inquiry as a way of knowing, or learning.

The US healthcare system is fragmented, chaotic and wasteful, and prevailing American social values and attitudes to health and healthcare are profoundly different from those found in the United Kingdom. Even so, there are many useful ideas and important lessons to be drawn from the US experience. The transfer of policy ideas and innovations needs, however, to take account of the differences in culture and context.

Presents research-based perspective on patient safety, drawing the ideas from researchers on how to research and understand patient safety issues, and how research findings are used to shape policy and practice. This book examines key issues including analysis and measurement of patient safety; approaches to improving patient safety; and others

"The performance of public services is now more closely scrutinised than ever before. Every teacher, doctor, social worker or probation officer knows that behind them stands a restless army of overseers, equipped with a panoply of league tables, star ratings, user opinion surveys, performance indicators and the like with which to judge them. This increased scrutiny and performance measurement has undoubtedly produced improved public services. Yet we still have a limited understanding about how this information can be best used to bring about improvements in performance. What goes on inside the 'black box' of public organisations to move from information to action, or from 'knowing' to 'doing'? This book tackles this important question by reviewing a wide range of performance mechanisms. It explores how information about performance can be translated into improvements in services and, conversely, why this does not always happen in practice"--

Background Many countries use external evaluation programmes such as accreditation in order to improve quality and safety in their healthcare settings. Hospital accreditation has developed in many low-and-middle-income countries (LMICs); however, the implementation and sustainability of these programmes vary in each country. This study addresses design and implementation issues of national hospital accreditation programmes. It identifies factors which may explain why programmes can be implemented successfully in one country but not in another and derives lessons for the design and implementation of national accreditation programmes in poor-resource settings. Methods A multiple case study design was used, comprising three countries in the Eastern Mediterranean Region: Egypt, Lebanon and Jordan. In-depth semi-structured interviews were conducted with 27 key stakeholders in the three countries and experts from international organisations concerned with accreditation activities in LMICs. Results The hospital accreditation programme was successful and sustainable in Jordan but experienced some difficulties in Egypt and Lebanon. The premature end of external funding and devastating political instability after the Arab Spring were problematic for the programmes in Egypt and Lebanon, but continuous funding and strong political will supported the implementation and sustainability of the programme in Jordan. Conclusions LMICs striving to improve their hospitals' performance through accreditation programmes should consider their vulnerability to a scarcity of financial resources and political instability. An important factor underpinning sustainability is recognising that the accreditation programme is an ongoing and developing quality improvement process that needs continuing and careful attention from funders and political systems if it is to survive and thrive.

Hospital accreditation has been transferred from high-income countries (HICs) to many low- and middle-income countries (LMICs), supported by a variety of advocates and donor agencies. This review uses a policy transfer theoretical framework to present a structured analysis of the development of hospital accreditation in LMICs. The framework is used to identify how governments in LMICs adopted accreditation from other settings and what mechanisms facilitated and hindered the transfer of accreditation. The review examines the interaction between national and international actors, and how international organizations influenced accreditation policy transfer. Relevant literature was found by searching databases and selected websites; 78 articles were included in the analysis process. The review concludes that accreditation is increasingly used as a tool to improve the quality of healthcare in LMICs. Many countries have established national hospital accreditation programmes and adapted them to fit their national contexts. However, the implementation and sustainability of these programmes are major challenges if resources are scarce. International actors have a substantial influence on the development of accreditation in LMICs, as sources of expertise and pump-priming funding. There is a need to provide a roadmap for the successful development and implementation of accreditation programmes in low-resource settings. Analysing accreditation policy processes could provide contextually sensitive lessons for LMICs seeking to develop and sustain their national accreditation programmes and for international organizations to exploit their role in supporting the development of accreditation in LMICs.