title: The PATH project in eight European countries: an evaluation.
abstract: OBJECTIVE
  This paper's aim is to evaluate the perceived impact and the enabling factors and barriers experienced by hospital staff participating in an international hospital performance measurement project focused on internal quality improvement.
  
  
  METHODS
  Semi-structured interviews involving international hospital performance measurement project coordinators, including 140 hospitals from eight European countries (Belgium, Estonia, France, Germany, Hungary, Poland, Slovakia and Slovenia). Inductively analyzing the interview transcripts was carried out using the grounded theory approach.
  
  
  RESULTS
  Even when public reporting is absent, the project was perceived as having stimulated performance measurement and quality improvement initiatives in participating hospitals. Attention should be paid to leadership/ownership, context, content (project intrinsic features) and processes supporting elements.
  
  
  CONCLUSIONS
  Generalizing the findings is limited by the study's small sample size. Possible implications for the WHO European Regional Office and for participating hospitals would be to assess hospital preparedness to participate in the PATH project, depending on context, process and structural elements; and enhance performance and practice benchmarking through suggested approaches.
  
  
  CONCLUSIONS
  This research gathered rich and unique material related to an international performance measurement project. It derived actionable findings.
authors.affiliation: Division of Research and Analysis, Canadian Institute for Health Information, Toronto, Canada. jeremyveillard@me.com
authors.forename: Jeremy Henri Maurice
authors.initials: JH
authors.lastname: Veillard
authors.affiliation: Steno Health Promotion Center, Steno Diabetes Centre, Copenhagen, Denmark.
authors.forename: Michaela Louise
authors.initials: ML
authors.lastname: Schiøtz
authors.affiliation: WHO Country Office, WHO Regional Office for Europe, Tunis, Tunisia.
authors.forename: Ann-Lise
authors.initials: AL
authors.lastname: Guisset
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
authors.forename: Adalsteinn Davidson
authors.initials: AD
authors.lastname: Brown
authors.affiliation: Department of Social Medicine, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
mesh_terms: D019985:Benchmarking; D005060:Europe; D006302:Health Services Research; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007391:International Cooperation; D007407:Interviews as Topic; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data