Organizational maturity as a tool for quality governance: a longitudinal study in a Brazilian hospital

Abstract Objective To analyze the evolution of organizational maturity and its role in supporting quality governance in a Brazilian hospital. Methods A longitudinal organizational study was conducted using a structured maturity assessment tool applied between 2020 and 2023. The instrument evaluated subsections across four domains: governance, patient care, diagnostics and therapeutics, and support services. A composite maturity index was calculated based on mean subsection scores. K-means cluster analysis was applied to standardized temporal trajectories to identify patterns of institutional development. Results The global maturity index increased from 0.279 in 2020 to 0.580 in 2023, representing an absolute increase of 0.301 (107.9% relative increase). Domain-level maturity in 2023 was highest in governance (0.619) and lowest in support services (0.510). Cluster analysis identified five distinct patterns of development, indicating heterogeneous trajectories across organizational domains. The greatest improvements were observed in pharmaceutical care, infection prevention and control, supply chain management, neonatal care, and specialized diagnostic services. Conclusion Organizational maturity models can support data-driven quality governance and improve decision-making processes in healthcare organizations.