Health care quality assurance: Difference between revisions

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imported>Robert Badgett
imported>Robert Badgett
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More experience, as measured by volume of care, is associated with better quality of care.<ref name="pmid18043982">{{cite journal |author=Lin HC, Xirasagar S, Lin HC, Hwang YT |title=Does physicians' case volume impact inpatient care costs for pneumonia cases? |journal=J Gen Intern Med |volume=23 |issue=3 |pages=304-9 |year=2008 |pmid=18043982 |doi=10.1007/s11606-007-0462-3 |url=http://dx.doi.org/10.1007/s11606-007-0462-3 |issn=}}</ref>
More experience, as measured by volume of care, is associated with better quality of care.<ref name="pmid18043982">{{cite journal |author=Lin HC, Xirasagar S, Lin HC, Hwang YT |title=Does physicians' case volume impact inpatient care costs for pneumonia cases? |journal=J Gen Intern Med |volume=23 |issue=3 |pages=304-9 |year=2008 |pmid=18043982 |doi=10.1007/s11606-007-0462-3 |url=http://dx.doi.org/10.1007/s11606-007-0462-3 |issn=}}</ref>


[[Process control chart]]s can be used to identify specific problems that need improvement.<ref name="pmid9499330">{{cite journal |author=Nelson EC, Splaine ME, Batalden PB, Plume SK |title=Building measurement and data collection into medical practice |journal=Ann. Intern. Med. |volume=128 |issue=6 |pages=460–6 |year=1998 |month=March |pmid=9499330 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=9499330 |issn=}}</ref><ref name="isbn0-527-76293-8">{{cite book |author=Lloyd, Robert M.; Carey, Raymond G. |authorlink= |editor= |others= |title=Measuring quality improvement in healthcare: a guide to statistical process control applications |edition= |language= |publisher=Quality Resources |location=White Plains, N.Y |year=1995 |origyear= |pages= |quote= |isbn=0-527-76293-8 |oclc= |doi= |url=http://books.google.com/books?id=J3eotrgx_4gC |accessdate=}}</ref><ref name="isbn0-87389-562-2">{{cite book |author=Stake, Larry V.; Carey, Raymond G. |authorlink= |editor= |others= |title=Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies |edition= |language= |publisher=ASQ Quality Press |location=Milwaukee, Wis |year=2002 |origyear= |pages= |quote= |isbn=0-87389-562-2 |oclc= |doi= |url= |accessdate=}}</ref> Examples are assessing methods to obtain blood cultures<ref name="pmid12585951">{{cite journal |author=Norberg A, Christopher NC, Ramundo ML, Bower JR, Berman SA |title=Contamination rates of blood cultures obtained by dedicated phlebotomy vs intravenous catheter |journal=JAMA |volume=289 |issue=6 |pages=726–9 |year=2003 |month=February |pmid=12585951 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12585951 |issn=}}</ref>, the impact of screening for methicillin resistant [[Staphylococcus aureus]]<ref name="pmid18334690">{{cite journal |author=Harbarth S, Fankhauser C, Schrenzel J, ''et al'' |title=Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients |journal=JAMA |volume=299 |issue=10 |pages=1149–57 |year=2008 |month=March |pmid=18334690 |doi=10.1001/jama.299.10.1149 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18334690 |issn=}}</ref> and comparing mortality in surgical units<ref name="pmid12689973">{{cite journal |author=Tekkis PP, McCulloch P, Steger AC, Benjamin IS, Poloniecki JD |title=Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data |journal=BMJ |volume=326 |issue=7393 |pages=786–8 |year=2003 |month=April |pmid=12689973 |doi=10.1136/bmj.326.7393.786 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12689973 |issn=}}</ref>.
[[Process control chart]]s can be used to identify specific problems that need improvement.<ref name="pmid9499330">{{cite journal |author=Nelson EC, Splaine ME, Batalden PB, Plume SK |title=Building measurement and data collection into medical practice |journal=Ann. Intern. Med. |volume=128 |issue=6 |pages=460–6 |year=1998 |month=March |pmid=9499330 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=9499330 |issn=}}</ref><ref name="isbn0-527-76293-8">{{cite book |author=Lloyd, Robert M.; Carey, Raymond G. |authorlink= |editor= |others= |title=Measuring quality improvement in healthcare: a guide to statistical process control applications |edition= |language= |publisher=Quality Resources |location=White Plains, N.Y |year=1995 |origyear= |pages= |quote= |isbn=0-527-76293-8 |oclc= |doi= |url=http://books.google.com/books?id=J3eotrgx_4gC |accessdate=}}</ref><ref name="isbn0-87389-562-2">{{cite book |author=Staker, Larry V.; Carey, Raymond G. |authorlink= |editor= |others= |title=Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies |edition= |language= |publisher=ASQ Quality Press |location=Milwaukee, Wis |year=2002 |origyear= |pages= |quote= |isbn=0-87389-562-2 |oclc= |doi= |url= |accessdate=}}</ref> Examples are assessing methods to obtain blood cultures<ref name="pmid12585951">{{cite journal |author=Norberg A, Christopher NC, Ramundo ML, Bower JR, Berman SA |title=Contamination rates of blood cultures obtained by dedicated phlebotomy vs intravenous catheter |journal=JAMA |volume=289 |issue=6 |pages=726–9 |year=2003 |month=February |pmid=12585951 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12585951 |issn=}}</ref>, the impact of screening for methicillin resistant [[Staphylococcus aureus]]<ref name="pmid18334690">{{cite journal |author=Harbarth S, Fankhauser C, Schrenzel J, ''et al'' |title=Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients |journal=JAMA |volume=299 |issue=10 |pages=1149–57 |year=2008 |month=March |pmid=18334690 |doi=10.1001/jama.299.10.1149 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18334690 |issn=}}</ref> and comparing mortality in surgical units<ref name="pmid12689973">{{cite journal |author=Tekkis PP, McCulloch P, Steger AC, Benjamin IS, Poloniecki JD |title=Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data |journal=BMJ |volume=326 |issue=7393 |pages=786–8 |year=2003 |month=April |pmid=12689973 |doi=10.1136/bmj.326.7393.786 |url=http://bmj.com/cgi/pmidlookup?view=long&pmid=12689973 |issn=}}</ref>.


==Public reporting of quality measures==
==Public reporting of quality measures==

Revision as of 13:30, 17 May 2008

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Health care quality assurance is "activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps."[1]

Creating quality measures

Creating quality measures from clinical practice guidelines can be problematic.[2]

Measuring quality

Chart abstraction may underestimate quality.[3]

Improving quality

More experience, as measured by volume of care, is associated with better quality of care.[4]

Process control charts can be used to identify specific problems that need improvement.[5][6][7] Examples are assessing methods to obtain blood cultures[8], the impact of screening for methicillin resistant Staphylococcus aureus[9] and comparing mortality in surgical units[10].

Public reporting of quality measures

A systematic review found that "publicly releasing performance data stimulates quality improvement activity at the hospital level. The effect of public reporting on effectiveness, safety, and patient-centeredness remains uncertain".[11]

References

  1. Anonymous (2024), Health care quality assurance (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Walter LC, Davidowitz NP, Heineken PA, Covinsky KE (2004). "Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure". JAMA 291 (20): 2466–70. DOI:10.1001/jama.291.20.2466. PMID 15161897. Research Blogging.
  3. How well does chart abstraction measure quality? A...[Am J Med. 2000 - PubMed Result]. Retrieved on 2008-02-12.
  4. Lin HC, Xirasagar S, Lin HC, Hwang YT (2008). "Does physicians' case volume impact inpatient care costs for pneumonia cases?". J Gen Intern Med 23 (3): 304-9. DOI:10.1007/s11606-007-0462-3. PMID 18043982. Research Blogging.
  5. Nelson EC, Splaine ME, Batalden PB, Plume SK (March 1998). "Building measurement and data collection into medical practice". Ann. Intern. Med. 128 (6): 460–6. PMID 9499330[e]
  6. Lloyd, Robert M.; Carey, Raymond G. (1995). Measuring quality improvement in healthcare: a guide to statistical process control applications. White Plains, N.Y: Quality Resources. ISBN 0-527-76293-8. 
  7. Staker, Larry V.; Carey, Raymond G. (2002). Improving Healthcare with Control Charts: Basic and Advanced SPC Methods and Case Studies. Milwaukee, Wis: ASQ Quality Press. ISBN 0-87389-562-2. 
  8. Norberg A, Christopher NC, Ramundo ML, Bower JR, Berman SA (February 2003). "Contamination rates of blood cultures obtained by dedicated phlebotomy vs intravenous catheter". JAMA 289 (6): 726–9. PMID 12585951[e]
  9. Harbarth S, Fankhauser C, Schrenzel J, et al (March 2008). "Universal screening for methicillin-resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients". JAMA 299 (10): 1149–57. DOI:10.1001/jama.299.10.1149. PMID 18334690. Research Blogging.
  10. Tekkis PP, McCulloch P, Steger AC, Benjamin IS, Poloniecki JD (April 2003). "Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data". BMJ 326 (7393): 786–8. DOI:10.1136/bmj.326.7393.786. PMID 12689973. Research Blogging.
  11. Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG (2008). "Systematic review: the evidence that publishing patient care performance data improves quality of care". Ann. Intern. Med. 148 (2): 111–23. PMID 18195336[e]

External links

  1. Iglehart JK (1996). "The National Committee for Quality Assurance". N. Engl. J. Med. 335 (13): 995-9. PMID 8786789[e]