What we have learned from the Deepening our Understanding of Quality Improvement of hospitals in Europe

In 2009, the authors launched "Deepening our Understanding of Quality Improvement in Europe" (DUQuE), an ambitious study on the effectiveness of quality improvement systems of hospitals in eight European countries. 

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They believe this to be the most comprehensive and detailed study of quality improvement systems to date in terms of the a priori development of a coherent theory to guide the measurement and analytical strategy, the diverse countries involved and the range of standardized data collected (including surveys, chart reviews, administrative data and organizational audit). 

Here they discuss the overarching lessons emerging from the study.