May 15, 2012
The aim of this guide is to encourage users of international comparisons of health and health care data to consider some of the factors that can influence variation between countries, and to assist them in interpreting the results. Drawing on a range of examples—using health and health care data for Organisation for Economic Co-operation and Development (OECD) countries—this guide highlights the types of question to consider about data quality, the basis for country selection and the techniques used to present the results. It is a general guide, and considering each of the factors presented here may not always be possible.
Posted in READ Portal, Reports & Papers, Uncategorized | Tagged with Benchmarking, Indicators, Statistics & numerical data | No Comments
May 7, 2012
“This analysis uses data from the Organization for Economic Cooperation and Development and other sources to compare health care spending, supply, utilization, prices, and quality in 13 industrialized countries: Australia, Canada, Denmark, France, Germany, Japan, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States. The U.S. spends far more on health care than any other country. However this high spending cannot be attributed to higher income, an older population, or greater supply or utilization of hospitals and doctors. Instead, the findings suggest the higher spending is more likely due to higher prices and perhaps more readily accessible technology and greater obesity. Health care quality in the U.S. varies and is not notably superior to the far less expensive systems in the other study countries. Of the countries studied, Japan has the lowest health spending, which it achieves primarily through aggressive price regulation.”
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Health care costs, Indicators, Quality assessment | No Comments
May 1, 2012
“Systems that provide healthcare workers with the opportunity to report hazards, hazardous situations, errors, close calls and adverse events make it possible for an organization that receives such reports to use these opportunities to learn and/or hold people accountable for their actions. When organizational learning is the primary goal, reporting should be confidential, voluntary and easy to perform and should lead to risk mitigation strategies following appropriate analysis; conversely, when the goal is accountability, reporting is more likely to be made mandatory. Reporting systems do not necessarily equate to safer patient care and have been criticized for capturing too many mundane events but only a small minority of important events. Reporting has been inappropriately equated with patient safety activity and mistakenly used for “measuring” system safety. However, if properly designed and supported, a reporting system can be an important component of an organizational strategy to foster a safety culture.
Healthcare is not as safe as it should or could be: rates of adverse events, defined as situations where patients suffer harm from the healthcare they receive (or not receiving care that would have helped), in acute care have been shown to be high. For example, the Canadian Adverse Events Study found that 7.5% of patients admitted to a Canadian hospital suffered an adverse event (Baker et al. 2004). The National Steering Committee on Patient Safety listed the comprehensive identification and the reporting of hazards as one of “nine key principles for action” that served as a foundation for the committee’s recommendations to make Canadian patients safer (National Steering Committee on Patient Safety 2002). Further, the committee recommended the adoption of non-punitive reporting policies within a quality improvement framework. Recently, the National System for Incident Reporting (Canadian Institute for Health Information 2011) was established by the Canadian Institute for Health Information, whose focus at the present time is incidents regarding hospital-based medication and intravenous fluids. The development of reporting systems to enhance patient safety has been proposed as a strategy in other countries; examples include the Australian Incident Monitoring System (Runciman 2002) and the National Reporting and Learning System in England and Wales (Williams and Osborn 2006).”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Canada, Quality improvement, Safety | No Comments
March 2, 2012
“The National Quality Forum (NQF), a private, nonprofit membership organization committed to improving health care quality performance measurement and reporting, was awarded a contract with the U.S. Department of Health and Human Services (HHS) to establish a portfolio of quality and efficiency measures. The portfolio of measures would allow the federal government to examine how and whether health care spending is achieving the best results for patients and taxpayers. As part of the scope of work under the HHS contract, NQF was required to conduct an independent evaluation of the uses of NQF-endorsed measures for the purposes of accountability (e.g., public reporting, payment, accreditation, certification) and quality improvement. In September 2010, NQF entered into a contract with the RAND Corporation for RAND to serve as the independent evaluator. This article presents the results of the evaluation study. It describes how performance measures are being used by a wide array of organizations and the types of measures being used for different purposes, summarizes key barriers and facilitators to the use of measures, and identifies opportunities for easing the use of performance measures moving forward.”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Efficiency, Program evaluation | No Comments
February 28, 2012
“Background: There is growing interest in applying lean thinking in healthcare, yet, there is still limited knowledge of how and why lean interventions succeed (or fail). To address this gap, this in-depth case study examines a lean-inspired intervention in a Swedish pediatric Accident and Emergency department.
Methods: We used a mixed methods explanatory single case study design. Hospital performance data were analyzed using analysis of variance (ANOVA) and statistical process control techniques to assess changes in performance one year before and two years after the intervention. We collected qualitative data through non-participant observations, semi-structured interviews, and internal documents to describe the process and content of the lean intervention. We then analyzed empirical findings using four theoretical lean principles (Spear and Bowen 1999) to understand how and why the intervention worked in its local context as well as to identify its strengths and weaknesses.
Results: Improvements in waiting and lead times (19-24%) were achieved and sustained in the two years following lean-inspired changes to employee roles, staffing and scheduling, communication and coordination, expertise, workspace layout, and problem solving. These changes resulted in improvement because they: (a) standardized work and reduced ambiguity, (b) connected people who were dependent on one another, (c) enhanced seamless, uninterrupted flow through the process, and (d) empowered staff to investigate problems and to develop countermeasures using a “scientific method”. Contextual factors that may explain why not even greater improvement was achieved included: a mismatch between job tasks, licensing constraints, and competence; a perception of being monitored, and discomfort with inter-professional collaboration.
Conclusions: Drawing on Spear and Bowen’s theoretical propositions, this study explains how a package of lean-like changes translated into better care process management. It adds new knowledge regarding how lean principles can be beneficially applied in healthcare and identifies changes to professional roles as a potential challenge when introducing lean thinking there. This knowledge may enable health care organizations and managers in other settings to configure their own lean program and to better understand the reasons behind lean’s success (or failure).”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Process improvement, Quality improvement | No Comments
January 27, 2012
“This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions’ experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff.
“Between 4 percent and 5 percent of hospitalizations result in a health care–associated infection (HAI), at tremendous cost to individuals who become infected and those who fund health care. One of the most common and preventable HAIs is the central line–associated bloodstream infection (CLABSI), which can result when a central venous catheter is not inserted cleanly or maintained properly. An estimated 43,000 CLABSIs occurred in hospitals in 2009 and nearly one of five infected patients died as a result. This case study is part of a series that describes practices used by four leading hospitals that eliminated CLABSIs in their ICUs.”
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Infection control, Prevention and control | No Comments
December 16, 2011
“One of the most common types of health care–associated infections is the central line–associated bloodstream infection (CLABSI), which can result when a central venous catheter is not inserted or maintained properly. About 43,000 CLABSIs occurred in hospitals in 2009; nearly one of five infected patients died as a result. This report synthesizes lessons from four hospitals that reported they did not experience any CLABSIs in their intensive care units in 2009. Lessons include: the importance of following evidencebased protocols to prevent infection; the need for dedicated teams to oversee all central line insertions; the value of participation in statewide, national, or regional CLABSI collaboratives or initiatives; and the necessity for close monitoring of infection rates, giving feedback to staff, and applying internal and external goals. The report also presents ways these hospitals are spreading prevention techniques to non-ICU units, and strategies for preventing other health care–associated infections.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Evidence-based, Prevention and control | No Comments
December 13, 2011
“This sixth edition of Health at a Glance provides the latest comparable data on different aspects of the performance of health systems in OECD countries. It provides striking evidence of large variations across countries in the costs, activities and results of health systems… The indicators presented in this publication have been selected on the basis of their policy relevance and data availability and comparability. The data come mainly from official national statistics, unless otherwise indicated.”
This resource contains information on a number of topics, with the main content headings as follows:
- Health Status;
- Non-medical Determinants of Health;
- Health Workforce;
- Health Care Activities;
- Quality of Care;
- Access to Care;
- Health Expenditure and Financing, and;
- Long-term Care.
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Access to care, Benchmarking, Funding, Quality of care, Statistics & numerical data | No Comments
December 8, 2011
“ABSTRACT: Recent reforms in Australia, England, and the Netherlands have sought to enhance the quality and accessibility of primary care. Quality improvement strategies include postgraduate training programs for family physicians, accreditation of general practitioner (GP) practices, and efforts to modify professional behaviors—for example, through clinical guideline development. Strategies for improving access include national performance targets, greater use of practice nurses, assured after-hours care, and medical advice telephone lines. All three countries have established midlevel primary care organizations both to coordinate primary care health services and to serve other functions, such as purchasing and population health planning. Better coordination of primary health care services is also the objective driving the use of patient enrollment in a single general practice. Payment reform is also a key element of English and Australian reforms, with both countries having introduced payment for quality initiatives. Dutch payment reform has stressed financial incentives for better management of chronic disease.
With well-developed primary care systems that have track records of strong performance, Australia, England, and the Netherlands offer some potentially useful lessons to the United States as it implements health care reforms. This brief outlines how primary care is provided in those three countries, it evaluates data on a range of primary care system performance indicators, and it examines the three countries’ major strategies for strengthening primary care:
- Promoting coordination of care;
- Reforming primary care payment;
- Improving quality and access.
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Health care reform, Primary health care, Quality control, Quality improvement | No Comments
December 1, 2011
“Learning From the Best: Benchmarking Canada’s Health System examines Canadians’ health status, non-medical determinants of health, quality of care and access to care. It is based on international results that appear in the OECD’s Health at a Glance 2011, which provides the latest statistics and indicators for comparing health systems across 34 member countries.”
“There is increasing interest in cross-country comparisons of the performance of national health systems. Enhancing accountability and promoting benchmarking and mutual learning are among the main reasons for looking at how health system performance varies across countries.1 Although there are methodological challenges in terms of having consistent and comparable data across countries, there is much to be gained from understanding how Canadian results compare with what is being achieved by other countries of similar economic size and income. These comparisons raise questions that can help us understand and determine the following:
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Canada | No Comments
Page 1 of 712345...»Last »
