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
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.”
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August 25, 2011
As private and public employers strive to improve workforce health and control healthcare costs, the patient centered medical home (PCMH) is emerging as an important strategic component
to achieve these goals. The PCMH enables clinicians to deliver better quality care more efficiently. Central attributes of the PCMH include a holistic, team-based approach to primary care that is accessible, coordinated, and comprehensive. PCMH incorporates re-engineering of office processes and payment systems to reward an ongoing primary care physician-patient relationship and high-quality, coordinated care. Through better informa- tion management, use of guidelines and coordinated care, PCMH can contribute to better quality of care, which, in turn, drives cost reductions through avoided hospitalizations and emergency department visits.
While employer interest in PCMH continues to rise, an important issue facing employers concerns the measurement of value of PCMH implementation. From a pragmatic perspective, this information is necessary to help justify initial and ongoing employer investments in PCMH. And despite this observation, there is no consensus regarding specific measures or metrics to evaluate PCMH program effectiveness.
Posted in READ Portal, Reports & Papers | Tagged with Cost effectiveness, Indicators, Patient-centered care, Program evaluation | No Comments
June 28, 2011
“To drive health equity into action we need to understand the needs of health disadvantaged populations, identify barriers to equitable access to quality care, and build equity into priority setting, resource allocation and performance management. Health Equity Impact Assessment is a practical and effective planning tool that analyzes the potential impact of service, program or policy changes on health disparities and/or health disadvantaged populations. It can help to plan new services or initiatives or assess and re-align existing programs; and using it has proven valuable to building awareness of and embedding equity within organizations. This is an overview primer that introduces the potential and practice of HEIA. We also have many other resources on our page on equity-focused planning.”
Posted in READ Portal, Reports & Papers | Tagged with Health care reform, Health equity, Health planning, Program evaluation | No Comments
April 26, 2011
“Variations in health care in the NHS are a persistent and ubiquitous problem. But which variations are acceptable or warranted – for example, variations driven by clinical need and informed patient choice – and which are not? The important question is how to promote ‘good’ variation and minimise ‘bad’ variation.
Variations in health care: The good, the bad and the inexplicable explores the possible causes of variation, shows the different ways in which variations can be measured, and analyses variations by PCT in rates of elective hospital admissions for selected procedures.
The causes of variation are complex and inter-related – they may be affected by, for example, differences in geographical patterns of illness, differences in clinicians’ behaviour, the effects of incentives in the financing of health care. These causes are mapped and discussed.”
Posted in Journal Articles, READ Portal | Tagged with Decision making, Policy, Program evaluation, Quality assessment, Quality control, Quality improvement, Safety | No Comments
February 10, 2011
Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo’s integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.
Posted in Journal Articles, READ Portal | Tagged with Benchmarking, Canada, Efficiency, Health care reform, Indicators, Program evaluation | No Comments
February 4, 2011
McKinsey Quarterly. (2010). “Frontline lessons in health care transformation: An interview with Brendan Drumm, MD.” Retrieved from https://www.mckinseyquarterly.com/Health_Care/Frontline_lessons_in_health_care_transformation_An_interview_with_Brendan_Drumm_MD_2692. Ireland’s HSE has improved care delivery significantly. Waiting lists have declined sharply. More patients have access to high-quality primary care. Hospital quality and safety have improved. In this interview, Brendan Drumm, the HSE’s first CEO, speaks frankly […]
Posted in Journal Articles, READ Portal | Tagged with Efficiency, Indicators, Program evaluation, Quality assessment | No Comments
February 3, 2011
This 2010 white paper from the Institute for Healthcare Improvement presents a synopsis of the results of the eight year Pursuing Perfection Initiative. The goal of the initiative was to determine how healthcare organizations could improve their operations in order to have more efficacious and efficient healthcare systems.
In order to achieve this, the 13 organisations from US and Europe “designed, tested, and implemented changes in strategy, structure, and key processes, supported by IHI faculty and with frequent contact with each other in a collaborative learning model.” The study ended with all participants demonstrating significant improvements in one or more areas of operations, while also learning about the critical factors of optimal healthcare performance.
Posted in READ Portal, Reports & Papers | Tagged with Benchmarking, Efficiency, Evidence-based, Health care reform, Health technology, Hospital administration, Indicators, Patient-centered care, Program evaluation, Quality assessment | No Comments
February 2, 2011
According to a new study conducted by researchers from the Stanford University School of Medicine, electronic health records (EHR) alone may not have an impact on healthcare performance. The researchers reviewed electronic record use from 2005 through 2007.
While most reviews of electronic health records look at how they function in a single, academic health organisation, this review takes a different approach. It reviewed all types of non-federal health organisations in the US to determine how, if at all, electronic health records are having an impact. The results of the study found that the is no difference in quality of care from the use of EHRs.
Posted in Mass Media Articles, READ Portal | Tagged with e-health, Program evaluation, Quality of care | No Comments
January 10, 2011
The authors of this paper conducted a detailed study of hospital performance over a four year period. Using difference-in-differences regression analysis they assessed improvement in hospital operations in myocardial infarction, heart failure, and pneumonia care. Results indicated that use of electronic health records can have a positive, negative, or null effect on hospital operations. Researchers suggest that hospitals need to employ a set of criterion for electronic health record measurement, functionality, and use.
Posted in Journal Articles, READ Portal | Tagged with e-health, Efficiency, Health technology, Hospital administration, Information technology, Program evaluation, Quality assessment, Safety | 1 Comment
