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This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
This new edition of this bestselling guide offers an integrated approach to process improvement that delivers quick and substantial results in quality and productivity in diverse settings. The authors explore their Model for Improvement that worked with international improvement efforts at multinational companies as well as in different industries such as healthcare and public agencies. This edition includes new information that shows how to accelerate improvement by spreading changes across multiple sites. The book presents a practical tool kit of ideas, examples, and applications.
Guidelines for the clinical practice of medicine have been proposed as the solution to the whole range of current health care problems. This new book presents the first balanced and highly practical view of guidelinesâ€"their strengths, their limitations, and how they can be used most effectively to benefit health care. The volume offers: Recommendations and a proposed framework for strengthening development and use of guidelines. Numerous examples of guidelines. A ready-to-use instrument for assessing the soundness of guidelines. Six case studies exploring issues involved when practitioners use guidelines on a daily basis. With a real-world outlook, the volume reviews efforts by agencies and organizations to disseminate guidelines and examines how well guidelines are functioningâ€"exploring issues such as patient information, liability, costs, computerization, and the adaptation of national guidelines to local needs.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
In microsystem thinking, the quality and value of care produced by a large health system can be no better than the services generated by the small systems of which it is composed. This edition explains how to integrate clinical microsystems and practice-based learning into your own organization.
The Clinical Practice Program: A How-to-Guide for Physician Leaders on Starting Up a Successful Program builds on the concept that successful programs can be differentiated from unsuccessful programs by seven core elements. Dr. Loftus describes his personal journey as a physician executive in implementing clinical practice changes for a large healthcare system. He demonstrates how to incorporate the seven core elements in the development, implementation and sustainability of a clinical practice program.
Rev. ed. of: Clinical improvement action guide / edited by Eugene C. Nelson, Paul B. Batalden, Jeanne C. Ryer. 1998.
Describes a superior model to guide empirical practice improvement projects This unique text provides the academic and clinical healthcare communities with a tested, practical, and successful model (EBPI+) to steer evidence-based practice improvement projects. The model--tested in multiple clinical settings--is distinguished from similar prototypes by its integration of the best EBP and quality/performance improvement principles (QI), resulting in a highly practical and comprehensible model for guiding students' and clinicians' work to improve quality outcomes in healthcare. The book emphasizes the need for collaboration among all stakeholders, particularly those in different disciplines with different perspectives, to provide greater clarity and enhance improvement work in a clinical agency. It features a blueprint for guiding healthcare improvements based on evidence that incorporates potential changes of direction midstream. The book also introduces tools for the evaluation of organizational commitment, stakeholder choice, and sustainability of improvement projects. Section One of the text focuses on the background and development of the original EBPI model, followed by, in Section Two, an elaboration of the components of the new enhanced model, EBPI+. Chapter authors in Section Three describe how they used the components of the EBPI model, discussing lessons learned from its use. This section, connecting the theoretical basis for this work with real-world applications, includes a template that readers can use to facilitate their own projects. The final section investigates future approaches to improvement work. Comprehensive appendices provide useful tools for students and clinicians to use in developing, implementing, and evaluating any EBPI+ projects. Key Features: Describes a practical and successful model incorporating the best of EBP and QI approaches (EPBI+) for improving quality outcomes in healthcare Incorporates a strong focus on how to determine and engage project stakeholders and provides tools for effective decision making Delineates specific methods to develop protocols for a small test of change prior to larger pilot studies Delivers approaches/strategies for monitoring and evaluating sustainability Discusses how to assess organizational commitment and conduct stakeholder analyses Creates examples that use each component of EBPI+ as a template for readers Emphasizes the "how to" of implementation more than other competitive models
This book focuses on the practical application of good clinical practice (GCP) fundamentals and provides insight into roles and responsibilities included in planning, executing, and analyzing clinical trials. The authors describe the design of quality into clinical trial planning and the application of regulatory, scientific, administrative, business, and ethical considerations. Describes the design of quality into the clinical trial planning Has end-of-chapter questions and answers to check learning and comprehension Includes charts that visually summarize the content and allow readers to cross-reference details in relevant chapters Offers a companion website containing supplemental training resources