Managing the gap between policy and practice through Intermediaries for Quality Improvement

Abstract

A gap exists between policymaking for quality improvement and the realization of these policies in practice. Using previous research on intermediaries, a conceptual model of an Intermediary for Quality Improvement (IQI) is developed. The model highlights the characteristics of structural positions, mediating approaches, and duration as a way to describe an IQI. The conceptual model is used to examine two cases in which Famna, the Swedish Association for Non-profit Health and Social Service Providers, has supported both policymaking and the implementation of policies at a provider level. The cases are the national strategy for quality improvement by open comparisons in health care and social services and a new regulation on quality management systems in health care and social services. Using the concept of an IQI deepens the understanding of how top-down and bottom-up perspectives may be managed to realize good quality of services.