March 21, 2012
“This toolkit is designed to help your hospital understand the Quality Indicators (QIs) from AHRQ, and support your use of them to successfully improve quality and patient safety in your hospital. Created by the RAND Corporation and the University HealthSystem Consortium with funding from AHRQ, it is available for all hospitals to use free of charge. The toolkit is a general guide to using improvement methods, with a particular focus on the QIs.
The AHRQ QIs use hospital administrative data to assess the quality of care provided, identify areas of concern in need of further investigation, and monitor progress over time. This toolkit focuses on the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs).”
Posted in Multimedia, READ Portal | Tagged with Indicators, Patient-centered care, Process improvement, Quality improvement, Safety | No Comments
March 1, 2012
“Health system stakeholders at different levels are focused more than ever on improvements to quality of care. With heart disease continuing to be a top health issue for Canadians, quality improvement initiatives aimed at improving cardiac care are increasingly important. The Cardiac Care Quality Indicators are one such initiative, with the goal of supporting cardiac care centres in their quality improvement efforts by providing comparable facility-level information on a number of cardiac quality outcome indicators. Working together, the Canadian Institute for Health Information and the Cardiac Care Network of Ontario completed the pilot project for this initiative in Ontario and British Columbia in 2010. Based on the success of the pilot, a national expansion of the initiative is currently under way. This article details some of the processes that led to the success of the project and presents some high-level, de-identified results.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Quality improvement, Quality of care | 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
February 20, 2012
“An emerging category of hospital quality initiatives, comparable to preventing medical errors and improving quality and patient safety, could be labeled “waste management” or “waste reduction.” “Waste” in this sense refers not to biohazardous substances in need of disposal, but to the overuse of medical resources—such as lab tests and pharmaceuticals—when they are not helpful to a patient’s medical management.”
“If patients are getting CAT scans they don’t really need or an extra day of telemetry because we don’t have criteria for who should be on telemetry, that’s wasteful, it’s costly, and it could be dangerous,” Dr. Wachter explained at the UCSF Management of the Hospitalized Patient meeting last October. “The data are clear that 30% of what we do in American medicine is of no value to patients—and some substantial portion of that is harmful as well. I think we as hospitalists should be identifying what these wasteful things are—and making the hard decisions to stop them.”
Posted in Mass Media Articles, READ Portal | Tagged with Process improvement, Quality improvement | No Comments
February 10, 2012
“Cultural competency in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients’ social, cultural and linguistic needs. A culturally competent health care system is one that acknowledges the importance of culture, incorporates the assessment of cross-cultural relations, recognizes the potential impact of cultural differences, expands cultural knowledge, and adapts services to meet culturally unique needs. Ultimately, cultural competency is recognized as an essential means of reducing racial and ethnic disparities in health care.
This guide explores the concept of cultural competency and builds the case for the enhancement of cultural competency in health care. It offers seven recommendations for improving cultural competency in health care organizations:
- Collect race, ethnicity and language preference (REAL) data.
- Identify and report disparities.
- Provide culturally and linguistically competent care.
- Develop culturally competent disease management programs.
- Increase diversity and minority workforce pipelines.
- Involve the community.
- Make cultural competency an institutional priority.”
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Quality improvement | No Comments
February 9, 2012
“At a time when hospitals are under pressure to improve quality and make productivity savings, they need to find tools to support them. Service-line management (SLM) and service-line reporting (SLR) offer one approach. Service-line management is a system in which a hospital trust is divided into specialist clinical areas that are then managed, by clinicians, as distinct operational units. SLM enables clinicians and managers to plan service activities, set objectives and targets, monitor financial and operational activity and manage performance. Service-line reporting provides the necessary data on financial performance, activity, quality and staffing.
Service-line management: Can it improve quality and efficiency? presents the findings from a series of interviews with staff at seven NHS trusts that are using SLM or SLR, revealing how they are implementing this approach and identifying what helps and what hinders this way of working.
The paper outlines a number of important issues for trusts to consider when introducing SLM.
- The role of the board – including the need for both clear and consistent executive support for using SLM and for executives to be willing to relinquish control over decisions and budgets.
- Clinical engagement – especially the need to provide support and training to enable clinicians to take on leadership and management roles and to develop shared and realistic goals.
- Data – including identifying and evaluating existing sources of data and the need to accept that the time needed to implement SLM, the value of the information obtained, and the ease of data collection will vary between service lines because of external and clinical factors.
- Resources – including the challenge of finding the time and resources to dedicate to the introduction of SLR and SLM and the need for well-resourced and suitably skilled financial and informatics support.
The paper concludes that implementing SLR and SLM well is challenging, but it works best when it is part of the overall management approach of the trust and its day-to-day way of working.”
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Quality assessment, Quality improvement | 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 2, 2011
“Change Foundation CEO Cathy Fooks says integrated healthcare is the key to better patient experiences, improved access to quality, safe services, and a stronger, sustainable healthcare system. But she says integrated healthcare is not yet possible in Ontario given the arrangements currently in place, adding that we need to create the winning conditions to yield a patient-centred system that provides value for our healthcare investments.
“The province is working on several fronts to improve healthcare quality, better serve patients and use resources more strategically. But we’re missing a game-changing shift,” says Fooks. “As long as the levers of healthcare change are grinding against each other, real progress will be slow. We need to embrace team-based care. We need to strengthen regional planning bodies by giving them the scope, support, and structure to do their job; and we need to ensure professional interests don’t trump big-picture decision-making and the voice of patients and caregivers.”
Winning Conditions recommends 24 interconnected actions to improve care, governance, funding, performance, and information flow, outlining where we stand now, and where we need to go to improve the patient and caregiver experience.
Winning Conditions is The Change Foundation’s best advice on how Ontario can move closer to an integrated health system and improve the experience of patients and their caregivers. It’s based on work conducted and commissioned by the Foundation and published research. It draws on what we’ve learned from other jurisdictions, and is informed by discussions with government, policy experts, regional planners, and most importantly, the people who use Ontario’s healthcare system.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Forecasting, Process improvement, Quality improvement | No Comments
November 30, 2011
“Background: In health care, many organizations are working on quality improvement and/ or innovation of their care practices. Although the effectiveness of improvement processes has been studied extensively, little attention has been given to sustainability of the changed work practices after implementation. The objective of this study is to develop a theoretical framework and measurement instrument for sustainability. To this end sustainability is conceptualized with two dimensions: routinization and institutionalization.
Methods: The exploratory methodological design consisted of three phases: a) framework development; b) instrument development; and c) field testing in former improvement teams in a quality improvement program for health care (N teams = 63, N individual =112). Data were collected not until at least one year had passed after implementation. Underlying constructs and their interrelations were explored using Structural Equation Modeling and Principal Component Analyses. Internal consistency was computed with Cronbach’s alpha coefficient. A long and a short version of the instrument are proposed.
Conclusions: The theoretical framework offers a valuable starting point for the analysis of sustainability on the level of actual changed work practices. Even though the two dimensions routinization and institutionalization are related, they are clearly distinguishable and each has distinct value in the discussion of sustainability. Finally, the sub scales conformed to psychometric properties defined in literature. The instrument can be used in the evaluation of improvement projects.”
Click here to read the full article
Posted in Journal Articles, READ Portal | Tagged with Process improvement, Quality assessment, Quality improvement | No Comments
November 23, 2011
“Since first being identified as a key best practice for surgical efficiency, perioperative supply chain improvements have become a growing area of interest. While participating in a pilot program, 14 Ontario hospitals that undertook improvement projects reported significant decreases in supply costs, greater staff efficiencies and an overall more collaborative work environment.
Their experiences, which serve to inform this guide, found savings from a series of foundational projects, mostly focusing on refining inventory data, managing procedure card systems, optimizing surgical inventory and storage, and standardizing product.
The clinical and non-clinical leaders of these projects, supported by a network of subject matter experts, worked together to develop the guide. Divided into five chapters, each examines one of four foundational projects: Procedure Card Management; Data Optimization; OR Inventory Optimization and Product Selection and Standardization, with a fifth chapter serving as a refresher on Project Management.”
Click here to read the full article
Posted in READ Portal, Reports & Papers | Tagged with Hospital administration, Process improvement, Quality improvement | No Comments
Page 2 of 6«12345...»Last »
