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.”
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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.
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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.
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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
November 14, 2011
“This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.”
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Evidence-based, Health technology assessment, Quality of care | No Comments
November 10, 2011
“In high-income countries, patients with complex care needs account for a disproportionate share of national health spending… These patients typically see multiple clinicians at different locations, making care coordination imperative. To learn more about the experiences of these “sicker adults,” a new Commonwealth Fund survey focused on patients with high care needs in 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S.
Despite variation in patients’ experiences across the globe, all countries are facing similar challenges in providing effective care to sicker adults, contending with coordination gaps, lapses in communication between providers, and missed opportunities for engaging patients in management of their own care. Moreover, all countries can learn from one another, the authors conclude.
(The bottom line is) across 11 countries, adults with complex care needs who had a medical home reported fewer coordination failures with their care, including medical errors and test duplication, as well as better relationships with their doctors and greater satisfaction with care.”
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Chronic disease, Integrated care, Quality assessment | No Comments
November 7, 2011
“Enhancing the coordination and quality of care for chronically ill patients is a challenge across health care systems. In Germany, following a 2002 reform, physician-based and patient-centered disease-management programs (DMPs) were implemented in a nationwide rollout. These programs are characterized by information technology support, the central role of a designated doctor in ambulatory care, a patient-centered approach that encourages patient self-management, quality assurance (including reminders and benchmarking), and financial incentives for physicians, patients, and sickness funds. Results of a four-year follow-up show that despite the programs’ implementation in a weak primary care system, quality of care and patient satisfaction have improved while hospitalization rates, duration of hospital stay, patient mortality, and drug costs have been significantly lowered. In some areas up to 90 percent of all eligible patients are enrolled, thereby giving the programs a broadly representative base.”
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Patient-centered care, Quality improvement | No Comments
November 3, 2011
“Several regional healthcare systems around the world have achieved high levels of performance through system-wide efforts to improve quality that include long-term strategies and investments to improve the delivery of care and outcomes, while limiting cost increases.
An analysis of three such systems in Alaska, Utah and Sweden suggests 10 themes underlying the creation and sustaining of high performance. These themes are:
- Quality and system improvement as a core strategy
- Developing organizational capabilities and skills to support improvement
- Robust primary care teams at the centre of the delivery system
- Engaging patients in their care and in the design of care
- Promoting professional cultures that support teamwork, continuous improvement and patient engagement
- More effective integration of care that promotes seamless care transitions
- Information as a platform for guiding improvement
- Effective learning strategies and methods to test and scale up improvements
- Leadership activities that embrace common goals and align activities throughout the organization
- Providing an enabling environment buffering short-term factors that undermine success.
Healthcare systems in Canada have experienced difficulties in creating and sustaining large-scale improvements; local initiatives are difficult to replicate and spread, and improvement efforts are often limited in scale.
Canada could support a broader strategy to implement many of the elements responsible for success in the three exemplary systems studied. These elements include:
- Expand and enhance the roles of quality councils and similar bodies to support the development of improvement skills and to facilitate system-wide efforts to improve the quality and efficiency of care
- Create greater local capacity for improvement through training and leadership development
- Place greater emphasis on physician leadership training to enhance organizational capability, not just individual capability
- Identify priority areas for improvement with specific targets and timelines to help align system-wide efforts
- Continue to focus on the development of electronic clinical information systems; but enhance supports for collecting and using data on current performance even if such data require manual collection
- Expand current projects to improve patient engagement in the design and improvement of care delivery in order to promote patient-centred care and to engage and align clinicians”
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Canada, Quality assessment, Quality improvement | No Comments
October 24, 2011
The adoption of the Balanced Scorecard philosophy of measure, monitor and manage by The Hospital for Sick Children (SickKids) has resulted in SickKids’ staff understanding, appreciating and ultimately being able to accept the enhanced transparency and accountability around performance, at both the system and hospital levels. The leadership of the organization observed these differences after initial SickKids scorecard update meetings, realizing this was not a flavour of the month but a totally new way of operating in a quest to achieve SickKids’ vision and mission. Almost immediately, the internal culture began to shift as staff better understood how their roles actively contribute to the organization’s ability to execute on its strategy. Based on 2010 staff engagement results, 70% of staff “see a direct link between personal work objectives and SickKids’ strategy,” while 60% were familiar with the newly released strategic plan, unprecedented results based on current benchmarks. This article provides an overview of the SickKids strategy management system, outlining both best practices and the journey from its launch to induction into the Balanced Scorecard Hall of Fame. Performance, at all levels across the enterprise, has shown measureable improvement with the introduction of the comprehensive strategy management system.
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Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Quality improvement | No Comments
October 11, 2011
Aims: The research reported in this document was designed to map the priority-setting activities taking place across the National Health Service (NHS) in England, and to explore and assess the effectiveness of these practices within specific local contexts.
The questions that provided the basis for the research were as follows:
- What priority-setting tools, processes and activities are practised currently as part of the commissioning processes of English primary care trusts (PCTs)?
- What barriers are experienced by PCTs seeking to implement explicit priority setting, and how are these being addressed?
- What other strengths and weaknesses can be identified in current priority-
setting practice?
- What learning can be derived that will be instructive for future priority setting within the NHS and elsewhere?
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Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Priority setting | No Comments
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