June 27, 2012
The Wait Time Alliance (WTA) has issued national report cards annually since 2007. Initially, our report cards were solely directed at provincial performance in the five areas identified in the 2004 Health Accord: cancer (radiation therapy); heart (bypass surgery); joint replacement (hip and knee); sight restoration (cataract) and diagnostic imaging (CT and MRI). Since then, the WTA has directed its attention
toward: (1) broadening the scope to include Canadians’ access to all areas of care; (2) improving the quality of public reporting on timely access; (3) highlighting issues that contribute to lengthy wait times; and, (4) identifying best practices to improve wait times.
The 2012 report card is the WTA’s most comprehensive effort to date to shed light on all of these areas.It contains six sections:
Posted in READ Portal, Reports & Papers | Tagged with Access to care, Benchmarking, Canada, Indicators, Wait lists | No Comments
June 22, 2012
Excerpt:
In this commentary, we hope to stimulate innovation in the field of health care performance measurement. We will discuss several considerations regarding the use of three quality indicators that are commonly used to improve accountability in the Canadian context. Specifically, we will focus on the hospital standardized mortality ratio (HSMR), all-cause urgent readmissions, and emergency department length of stay (ED-LOS; see Textbox 1). We discuss “the good,” “the bad,” and “the ugly” to illustrate both positive and negative consequences related to measurement. We conclude with specific recommendations regarding investments to improve quality measurement.
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Canada, Indicators, Mortality rates, Program evaluation, Statistics & numerical data | No Comments
June 1, 2012
“Abstract: Benchmarking, a management approach for implementing best practices at best cost, is a recent concept in the healthcare system. The objectives of this paper are to better understand the concept and its evolution in the healthcare sector, to propose an operational definition, and to describe some French and international experiences of benchmarking in the healthcare sector. To this end, we reviewed the literature on this approach’s emergence in the industrial sector, its evolution, its fields of application and examples of how it has been used in the healthcare sector.”
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Quality improvement | No Comments
May 30, 2012
“There is growing interest in the systematic assessment and international benchmarking of quality of care provided in different healthcare systems, and major work is under way to support this process through the development and validation of quality indicators that can be used internationally…
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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
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