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How can the quality of service provision and clinical governance in primary care be assessed? This book is designed to help evaluate the way practices interpret their legal obligations, the way the management systems within practices run, and the quality of the systems and processes that most affect the patient care. Quantifying Quality in Primary Care contains frameworks on which to build policies for the smooth running of practices and provides clear insights into attitudes of those working within them, and how to use this information to improve service provision. This straightforward, concise guide will help general practitioners, registrars and managers in primary care improve both service provision and management in the practice.
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
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 ground-breaking book addresses the critical, growing need among health care administrators and practitioners to measure the effectiveness of quality improvement efforts. Written by respected healthcare quality professionals, Measuring Quality Improvement in Healthcare covers practical applications of the tools and techniques of statistical process control (SPC), including control charts, in healthcare settings. The authors' straightforward discussions of data collection, variation, and process improvement set the context for the use and interpretation of control charts. Their approach incorporates "the voice of the customer" as a key element driving the improvement processes and outcomes. The core of the book is a set of 12 case studies that show how to apply statistical thinking to health care process, and when and how to use different types of control charts. The practical, down-to-earth orientation of the book makes it accessible to a wide readership. "Only authors who have used statistics and control charts to solve real-world healthcare problems could have written a book so practical and timely." - Barry S. Bader, Publisher The Quality Letter for Healthcare Leaders "Many clinicians and other healthcare leaders underestimate the great contributions that better statistical thinking could make toward reducing costs and improving outcomes. This fascinating and timely book is a fine guide for getting started." - Donald M. Berwick, M.D. President and CEO, Institute for Healthcare Improvement Associate Professor of Pediatrics, Harvard Medical School Contents: Planning Your CQI Journey, Preparing to Collect Data, Data Collection, Understanding Variation, Using Run and Control Charts to Analyze Process Variation, Control Chart Case Studies, Developing Improvement Strategies, Using Patient Surveys for CQI, Formulas for Calculating Control Limits
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.
This book offers a comprehensive guide to measures of health and is an essential reference resource for all health professionals and students.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
This book provides up-to-date resources and examples of outcome measures, tools and methods that can be used by APNs in their quest to keep pace with new developments in the rapidly expanding field of outcome measurement. The chapter authors, recognized expert practitioners, offer invaluable insight into the process of conducting outcomes assessments in all APN practice, including the clinical nurse, nurse practitioner, certified registered nurse anesthetist and certified nurse midwife practice specialties. Detailed figures, tables, and examples of outcome studies from actual research in APN practice make this an essential resource for evaluating the true impact the advanced practice nurse has on the delivery and fulfillment of care.
Health literacy-the ability for individuals to obtain, process, and understand basic health information and services to facilitate appropriate health decisions-is increasingly recognized as an important facet of health care and health outcomes. Although research on health literacy has grown tremendously in the past decade, there is no widely agreed-upon framework for health literacy as a determinant of health outcomes. Most instruments focus on assessing an individual's health literacy, yet the scope of health literacy reaches far beyond an individual's skills and abilities. Health literacy occurs in the context of the health care system, and therefore measures of health literacy must also assess the demands and complexities of the health care systems with which patients interact. For example, measures are needed to determine how well the system has been organized so that it can be navigated by individuals with different levels of health literacy and how well health organizations are doing at making health information understandable and actionable. To examine what is known about measures of health literacy, the Institute of Medicine convened a workshop. The workshop, summarized in this volume, reviews the current status of measures of health literacy, including those used in the health care setting; discusses possible surrogate measures that might be used to assess health literacy; and explores ways in which health literacy measures can be used to assess patient-centered approaches to care.