Full text
2/2026
vol. 28
Original paper
Implementation of quality management systems in small primary health care institutions: from formality to value creation
Department of Nursing, SMK College of Applied Sciences, Klaipeda, Lithuania
Family Medicine & Primary Care Review 2026; 28(2): 171–180
Data publikacji online: 2026/06/22
- Endalamaw A, Khatri RB, Mengistu TS, et al. A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact. BMC Health Serv Res 2024; 24(1): 487, doi: 10.1186/s12913-024-10828-0.
- Saulpic O, Zarlowski P, Berard E, et al. Quality improvement interventions and the transformation of organizational practices: a review of health sector and general management literature. Manage Int 2024; 29, doi: 10.59876/a-e52f-mynt.
- Young M, Smith MA. Standards and evaluation of healthcare quality, safety, and person-centered care. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2026.
- Woo K, Dowding D. Characteristics of quality improvement champions in nursing homes: a systematic review with implications for evidence-based practice. Worldviews Evid Based Nurs 2017; 14, doi: 10.1111/wvn.12262.
- Mutlu H, Baykara Mat ST. Accreditation through the eyes of nurse managers: an infinite staircase or a phenomenon that evaporates like water. J Health Organ Manag 2025; 39(8): 1885–1906, doi: 10.1108/JHOM-01-2025-0029.
- Budrevičiūtė A, Kalėdienė R, Petrauskienė J. Priorities in effective management of primary health care institutions in Lithuania: perspectives of managers of public and private primary health care institutions. PLOS ONE 2018; 13(12): e0209816, doi: 10.1371/journal.pone.0209816.
- Bankauskaite V, Jakusovaite I. Dealing with ethical problems in the healthcare system in Lithuania: achievements and challenges. J Med Ethics 2006; 32(10): 584–587, doi: 10.1136/jme.2005.014761.
- Bierbaum M, Best S, Williams S, et al. The integration of quality improvement and implementation science methods and frameworks in healthcare: a systematic review. BMC Health Serv Res 2025; 25, doi: 10.1186/s12913-025-12730-9.
- Gomes J, Romão M. Evaluating maturity models in healthcare information systems: a comprehensive review. Healthcare (Basel) 2025; 13(15): 1847, doi: 10.3390/healthcare13151847.
- Fischer A, Shapiro J, Nguyen T, et al. Views from the trenches: California family physicians’ challenges and resilience factors while providing patient care during the initial wave of COVID-19. Qual Res Med Healthc 2022; 6(2): 10296, doi: 10.4081/qrmh.2022.10296.
- Ding X, Shen W, Wang S. Centralized or decentralized? Communication network and collective effectiveness of PBOs – A task urgency perspective. Buildings 2024; 14: 448, doi: 10.3390/buildings14020448.
- Caci L, Nyantakyi E, Blum K, et al. Organizational readiness for change: a systematic review of the healthcare literature. Implement Res Pract 2025; 6: 26334895251334536, doi: 10.1177/26334895251334536.
- Montenegro Méndez S, Laguía González A, Moriano León JA. Is leadership a resource? A systematic review of its role in burnout and engagement among nurses within the JD-R model. J Nurs Manag 2025; 2025: 8853148, doi: 10.1155/jonm/8853148.
- Boiko O, Campbell JL, Elmore N, et al. The role of patient experience surveys in quality assurance and improvement: a focus group study in English general practice. Health Expect 2015; 18(6): 1982–1994, doi: 10.1111/hex.12298.
- Coles E, Anderson J, Maxwell M, et al. The influence of contextual factors on healthcare quality improvement initiatives: a realist review. Syst Rev 2020; 9(1): 94, doi: 10.1186/s13643-020-01344-3.
- Priyana I, Ningrum I, Rizani A. The role of HRM in developing technology-based competencies. Maneggio 2025; 2: 42–52, doi: 10.62872/40697450.
- Solberg LI, Asche SE, Margolis KL, et al. Measuring an organization’s ability to manage change: the Change Process Capability Questionnaire and its use for improving depression care. Am J Med Qual 2008; 23: 193–200, doi: 10.1177/1062860608314942.
- Alodhialah AM. Exploring the influence of organizational culture on evidence-based practice adoption among nurses in tertiary hospitals: a qualitative study. BMC Nurs 2025; 24(1): 1029, doi: 10.1186/s12912-025-03647-z.
- Lemque R, Gatoc A, Bragas C. A qualitative study on leadership and workplace culture: its impact on talent acquisition, employee engagement, and retention. Int J Res Publ Rev 2025; 6(1): 4582–4603.
- Gil-Ozoudeh I, Attah R, Garba B, et al. Cross-functional team dynamics in technology management: a comprehensive review of efficiency and innovation enhancement. Eng Sci Technol J 2024; 5, doi: 10.51594/estj.v5i12.1756.
- Marzban S, Najafi M, Agolli A, et al. Impact of patient engagement on healthcare quality: a scoping review. J Patient Exp 2022; 9: 23743735221125439, doi: 10.1177/23743735221125439.
- Alqallaf A. The impact of integrated patient education on short-term revisit rates in healthcare settings: a quality improvement project. Cureus 2024; 16(3): e56512, doi: 10.7759/cureus.56512.
- De Rosis S, Ferrè F, Pennucci F. Including patient-reported measures in performance evaluation systems: patient contribution in assessing and improving healthcare systems. Int J Health Plann Manage 2022; 37(Suppl 1): 144–165, doi: 10.1002/hpm.3596.
- Morales J, Silva-Aravena F, Saez P. Reducing waiting times to improve patient satisfaction: a hybrid strategy for decision support management. Mathematics 2024; 12(23): 3743, doi: 10.3390/math12233743.
- Coury J, Schneider JL, Rivelli JS, et al. Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Serv Res 2017; 17(1): 411, doi: 10.1186/s12913-017-2364-3.
- Taylor MJ, McNicholas C, Nicolay C, et al. Systematic review of the application of the Plan-Do-Study-Act method to improve quality in healthcare. BMJ Qual Saf 2014; 23(4): 290–298, doi: 10.1136/bmjqs-2013-001862.
- Iversen HW, Riley H, Råbu M, et al. Building and sustaining therapeutic relationships across treatment settings: a qualitative study of how patients navigate the group dynamics of mental healthcare. BMC Psychiatry 2025; 25(1): 424, doi: 10.1186/s12888-025-06874-5.
- Piekarska K, Bednarski P, Politynska B, et al. The impact of implementing indicators of quality of oncological care on improving patient outcomes: a cross-sectional review of experiences from countries using indicators in the quality assessment process. Cancers (Basel) 2025; 17(8): 1362, doi: 10.3390/cancers17081362.
- El Manzani Y. Quality mindset: applying implicit theories to quality management. Int J Qual Reliab Manag 2026; 43(3): 784–815, doi: 10.1108/IJQRM-05-2025-0153.
- Rawshdeh M, Keathley H, Obeidat S, et al. Factor analysis of quality management systems implementation in healthcare: an online survey. Healthcare (Basel) 2022; 10(10): 1828, doi: 10.3390/healthcare10101828.
- Petryk S, Andrieiev I, Tishko D, et al. The effectiveness of quality management strategies in healthcare organizations: an analysis of quality standards implementation and clinical performance improvement. Rev Amazonia Investiga 2023; 12: 333–345, doi: 10.34069/AI/2023.68.08.31.
- Alogla A. Revisiting lean healthcare: adopting value stream mapping from manufacturing. Front Health Serv 2025; 5: 1613756, doi: 10.3389/frhs.2025.1613756.
- Wong E, Mavondo F, Fisher J. Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence. BMC Health Serv Res 2020; 20(1): 530, doi: 10.1186/s12913-020-05383-3.
- Cascini F, Santaroni F, Lanzetti R, et al. Developing a data-driven approach in order to improve the safety and quality of patient care. Front Public Health 2021; 9: 667819, doi: 10.3389/fpubh.2021.667819.
- Demirci D, Minhas MH, Lokker C, et al. Primary care physicians’ perspectives on digital health tools for chronic disease management: a rapid review. PLOS Digit Health 2025; 4(11): e0001085, doi: 10.1371/journal.pdig.0001085.
- Eshete BA, Kassahun T. Adaptive leadership, organizational culture and patient-perceived service quality in private healthcare: evidence from Addis Ababa. Int J Health Care Qual Assur 2026; 39(2): 151–166, doi: 10.1108/IJHCQA-09-2025-0136.
- Health Statistics of Lithuania 2024. Vilnius: Health Information Centre, Institute of Hygiene; 2025.
- Shaheen N, Shaheen A, Ramadan A, et al. Appraising systematic reviews: a comprehensive guide to ensuring validity and reliability. Front Res Metr Anal 2023; 8: 1268045, doi: 10.3389/frma.2023.1268045.
- Campbell S, Greenwood M, Prior S, et al. Purposive sampling: complex or simple? Research case examples. J Res Nurs 2020; 25(8): 652–661, doi: 10.1177/1744987120927206.
- Astiena AK, Asdi Y, Hadiguna RA. Beyond the standard: rethinking Likert scale use in measuring patient satisfaction at public health center in Indonesia. J Public Health Res 2026; 15(2): 22799036261441329, doi: 10.1177/22799036261441329.
- Hussey I, Alsalti T, Bosco F, et al. An aberrant abundance of Cronbach’s alpha values at .70. Adv Methods Pract Psychol Sci 2025; 8, doi: 10.1177/25152459241287123.
- Simion Ludușanu DG, Fertu DI, Tinică G, et al. Integrated quality and environmental management in healthcare: impacts, implementation, and future directions toward sustainability. Sustainability 2025; 17(11): 5156, doi: 10.3390/su17115156.
- Shi P. Feasibility analysis of total quality management in medical quality management and its impact on work efficiency. Front Med (Lausanne) 2025; 12: 1701801, doi: 10.3389/fmed.2025.1701801.
- Platania S, Maggio C, Boccadamo M. The impact of diversity inclusion practices in the workplace context: the effect of inclusive leadership. Eur J Investig Health Psychol Educ 2025; 15(7): 121, doi: 10.3390/ejihpe15070121.
Copyright: © 2026 Family Medicine & Primary Care Review. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.