June 26, 2012
Summary: As patients live longer, many states, community-based coalitions, and health care providers have begun to focus on the quality—and quantity—of medical care provided at the end of life. The resulting programs have provided physicians with techniques for delivering bad news, managing transitions to palliative care, and handling requests for therapies that are likely to be futile. They’ve also helped to elicit patient preferences, leading to lower utilization in some locations.
Posted in Mass Media Articles, READ Portal | Tagged with Decision making, Palliative care, Quality of care | No Comments
June 14, 2012
Abstract:
Practice coaching, also called practice facilitation, assists physician practices with the desire to improve in such areas as patient access, chronic and preventive care, electronic medical record use, patient-centeredness, cultural competence, and team-building. This issue brief clarifies the essential features of practice coaching and offers guidance for health system leaders, public and private insurers, and federal and state policymakers on how best to structure and design these programs in primary care settings. Good-quality evidence demonstrates that practice coaching is effective. The authors argue that primary care delivery in the United States would benefit from a more systematic approach to the training and deployment of primary care practice coaches.
Posted in READ Portal, Reports & Papers | Tagged with Patient-centered care, Primary health care, Quality improvement, Quality of care | No Comments
June 13, 2012
Summary:
Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing patients’ preferences for their care. Because doctors are rarely made aware of an erroneous preference diagnosis, it could be called ‘the silent misdiagnosis’. Misdiagnosing patients’ preferences may be less obvious than misdiagnosing disease, but the consequences for the patient can be just as severe.
Posted in READ Portal, Reports & Papers | Tagged with Disease management, Patient satisfaction, Quality of care | No Comments
June 8, 2012
This is the sixth issue of Patient Safety Papers, published by Longwoods. The first five issues, published since 2005, presented reports on research studies, demonstration projects and leading practices from organizations across Canada. In this issue, we assess our progress and examine the future. To do so, we asked a selection of patient safety experts from across this country to reflect on critical patient safety initiatives in specific domains.
Articles in this issue cover various aspects of patient safety, including:
- The use of reporting systems to enhance organizational learning and create safer systems
- How teamwork and communication can contribute to patient safety events
Posted in Journal Articles, READ Portal | Tagged with Canada, Hospitals, Quality of care, Safety | No Comments
May 28, 2012
“Abstract: The ratio of patients to physicians has long been used as a tool for measuring and planning healthcare resources in Canada. Some current changes in primary care, such as enrolment of patients with physicians, make this ratio easier to calculate, while others, such as changing practice structure, make it more complex to interpret. Based on information gleaned from a review of the literature, we argue that before panel size can be used as an accountability measure for individual physicians or practices in primary care, we must understand its relationship to quality and outcomes at individual and population levels, as well as the contextual factors that affect it.”
Posted in Journal Articles, READ Portal | Tagged with Canada, Primary health care, Quality assessment, Quality of care | No Comments
May 17, 2012
“Key messages:
Continuity is fundamental to high-quality care. Without it, care is unlikely to be clinically effective, safe, personalised, efficient or cost-effective. Breakdowns in continuity of care put patients at risk, cause duplication and add avoidable costs to both health and social care.
This paper focuses on the experiences of older people with multiple health problems, and particularly on their experiences inside hospital. Continuity is especially important for these older patients because: they are more likely to spend time in hospital and to be in hospital for longer; if they are frail, a stay in hospital can be life-changing; and, regrettably, in some hospitals and some wards older patients are exposed to unacceptable standards of care….”
Posted in READ Portal, Reports & Papers | Tagged with Health services for the aged, Hospitals, Patient-centered care, Quality of care | No Comments
April 24, 2012
“The Canadian Hospital Reporting Project (CHRP) is a national quality improvement initiative from the Canadian Institute for Health Information (CIHI). CHRP’s web-based, interactive tool gives hospital decision-makers, policy-makers and Canadians access to indicator results for more than 600 facilities from every province and territory in Canada.
CIHI selected 21 clinical and 9 financial indicators for CHRP, based on their relevance to performance measurement and quality improvement. The selected indicators measure:
- Clinical effectiveness;
- Patient safety;
- Appropriateness of care;
- Accessibility; and
- Financial performance.
These indicators were chosen after reviewing existing hospital performance indicators and collaborating with experts in the field. The goal of CHRP is to foster quality improvement, learning and action.
Posted in Multimedia, READ Portal | Tagged with Canada, Patient-centered care, Quality of care, 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 14, 2012
“The ultimate goal of this study was to help providers of healthcare within Pennsylvania acute care hospitals find solutions to the ever-present problem of the occurrence of medical errors. Scholarly literature states that the majority of medical errors occur due to systems that breakdown and fail healthcare workers. This study sought to provide new knowledge in regard to where one particular system may be breaking down, specifically the error reporting system. The purpose of this study was twofold; 1) to develop two structured interview questionnaires, and 2) to conduct structured interviews as a means to collect data that focused on the occurrence of medical errors; specifically through assessing the error reporting systems within a sample of Pennsylvania acute care hospitals.
This researcher investigates the procedures taken by healthcare administrators within Pennsylvania acute care hospitals with respect to the detection of medical errors in order to provide corrective measures. In response to structured interview questions, the overwhelming majority of research participants stated that the procedures for corrective actions focused upon various training interventions as deemed appropriate by management. However, scholarly literature states that the majority of medical errors do not occur due to the lack of competence, skills, or knowledge of healthcare professionals. Thus, using training interventions to solve non-training problems may not prove effective. The outcome of the study has lead to several important implications for the healthcare industry.”
Posted in Journal Articles, READ Portal | Tagged with Prevention and control, Quality of care, Risk assessment, Safety | No Comments
January 11, 2012
“It has become a core belief in U.S. health care that improving clinical quality will reduce health care costs. It seems intuitive that reducing readmissions, shortening lengths of stay, and building efficiency into clinical processes will reduce resource utilization and thereby lower costs. Certainly, evidence suggests that there is no association between high quality and high costs. Yet true bottom-line savings from improved clinical quality rarely materialize, and costs continue to climb. Manufacturing and service companies around the world have demonstrated the cost benefits of improving product quality and production efficiency. So why haven’t nearly two decades of work on improving health care quality had a measurable effect on health care costs?”
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Posted in Journal Articles, READ Portal | Tagged with Quality assessment, Quality of care | No Comments
