Abstract
This study aimed to identify institutional strategies that strengthen the quality of care in health services through a systematic review of scientific literature. Multiple databases and indexed journals were consulted, covering the period from 2021 to 2025 in both Spanish and English. A total of 32 articles addressing key dimensions of quality were selected, including tangibles, reliability, responsiveness, safety, and empathy. The results revealed a predominantly traditional approach focused on these components, along with emerging classifications that emphasize the need for management tools, self-assessment, audits, and regulatory compliance. Furthermore, the findings highlight the importance of institutional leadership, the participation of internal and external stakeholders, and the development of organizational capabilities to implement comprehensive quality models. It is concluded that the identified strategies should be adopted as sustainable institutional policies, aligned with governance structures and aimed at improving healthcare delivery.
References
M. Arce and R. Aliaga, “Quality of care and user satisfaction in an Emergency Service of a Social Security Hospital,” Acta Médica Peruana, vol. 40, no. 4, pp. 308–313, 2023, doi: 10.35663/amp.2023.404.2722.
Á. Benites, E. Castillo, C. Rosales, R. Salas, and C. Reyes, “Factores asociados a la calidad del servicio en hospitales públicos peruanos,” Medisur, vol. 19, no. 2, pp. 236–244, 2021, disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2021000200236.
M. Bustamante, M. del C. Lapo, and M. Tello, “Modelamiento estructural de la calidad de servicio en atención primaria de salud del Guayas, Ecuador,” Información Tecnológica, vol. 33, no. 4, pp. 171–180, 2022, doi: 10.4067/S0718-07642022000400171.
M. Chirinos, C. Orrego, C. Montoya, and R. Suñol, “Predictors of patient safety culture in hospitals in Venezuela: A cross-sectional study,” Medicine, vol. 100, no. 18, p. e25316, 2021, doi: 10.1097/MD.0000000000025316.
T. L. Dadi, T. A. Abebo, A. Yeshitla, Y. Abera, D. Tadesse, S. Tsegaye, M. J. Gerbaba, M. D. Worke, D. Tadesse, and G. Medhin, “Impact of quality improvement interventions on facility readiness, quality and uptake of maternal and child health services in developing regions of Ethiopia: a secondary analysis of programme data,” BMJ Open Quality, vol. 12, no. 4, p. e002140, nov 2023, pMID: 37923343; PMCID: PMC10626795. doi: 10.1136/bmjoq-2022-002140.
A. Danet and J. Pérez-Lázaro, “Metodologías Lean en salud,” Revista de Gerencia y Política de Salud, vol. 23, pp. 1–22, 2024, disponible en: https://revistas.javeriana.edu.co/index.php/gerepolsal/article/view/38105.
A. Endalamaw, R. B. Khatri, T. S. Mengistu et al., “A scoping review of continuous quality improvement in healthcare system: conceptualization, models and tools, barriers and facilitators, and impact,” BMC Health Services Research, vol. 24, p. 487, 2024, doi: 10.1186/s12913-024-10828-0.
L. Esteve-Matalí, I. Vargas, F. Cots, I. Ramon, E. Sánchez, A. Escosa, and M.-L. Vázquez, “¿la integración de la gestión de servicios sanitarios mejora la coordinación clínica? Experiencia en Cataluña,” Gaceta Sanitaria, vol. 36, no. 4, pp. 324–332, 2022, iSSN 0213-9111. doi: 10.1016/j.gaceta.2021.06.004.
P. Hernández, “La calidad de la atención como eje de los sistemas de salud,” Salud Pública de México, vol. 66, no. 5, pp. 644–652, 2024.
Organización Mundial de la Salud (OMS), “Servicios de salud de calidad,” En línea, 2025, disponible en: https://www.who.int/es/news-room/fact-sheets/detail/quality-health-services.
A. Gonzáles, S. Oblitas, R. Mosqueira, and F. Heredia, “Liderazgo transformacional en gestión hospitalaria: una revisión bibliográfica,” Acta Médica del Centro, vol. 17, no. 4, pp. 819–834, 2023.
Y. Monsalve and M. Calvo, “Mejora continua en la gestión de servicios de salud: estrategias para la excelencia administrativa,” epsir, vol. 9, pp. 1–16, 2024.
E. Pabón, J. Mora, C. Buitrago, and R. Castiblanco, “Estrategias para fortalecer la humanización de los servicios en salud en urgencias,” Revista Ciencia y Cuidado, vol. 18, no. 1, pp. 94–104, 2021, doi: 10.22463/17949831.2512.
G. Padilla and D. Calvopiña, “La empatía y la prestación de los servicios de la salud del Centro de Especialidades La Ecuatoriana IESS,” Revista Científica Internacional, vol. 11, no. 2, pp. 472–484, 2024.
T. Gámez, L. Matos, R. González, and R. Labori, “Eficacia, efectividad, eficiencia y equidad en relación con la calidad en los servicios de salud,” INFODIR, vol. 17, no. 35, pp. 1–27, 2021.
A. D. Gage, T. Gotsadze, E. Seid, R. Mutasa, and J. Friedman, “The influence of Continuous Quality Improvement on healthcare quality: A mixed-methods study from Zimbabwe,” Social Science & Medicine, vol. 298, p. 114831, apr 2022, epub 2022 Feb 17. PMID: 35231780. doi: 10.1016/j.socscimed.2022.114831.
R. Mehra and M. K. Sharma, “Measures of sustainability in healthcare,” Sustainability Analytics and Modeling, vol. 1, p. 100001, 2021, iSSN 2667-2596. doi: 10.1016/j.samod.2021.100001.
D. Szulik, “Reflexiones en torno a la calidad de la atención en salud,” Ciencia, Docencia y Tecnología, vol. 34, no. 67, pp. 1–15, 2023, doi: 10.33255/3467/1291.
S. González-Rodríguez, R. Rivas-Ruiz, C. J. Espinosa-Rafful, M. A. Montano-López,A. Robles-Rodríguez, A. Rivera-Tellez, R. Pelayo, L. C. Bonifaz, and L. A. G. O.-G. Cuesta, “Las TIC en la evaluación de la calidad de la atención médica,” Revista Médica del Instituto Mexicano del Seguro Social, vol. 63, no. 2, p. e6209, 2025, doi: 10.5281/zenodo.14901762.
S. Zeh, E. Christalle, J. Zill, and M. Härter, “What do patients expect? Assessing patient-centredness from the patient’s perspective,” BMJ Open, vol. 11, no. 2, p. e047810, 2021, doi: 10.1136/bmjopen-2020-047810.
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