Quality improvement
Quality improvement is "the attainment or process of attaining a new level of performance or qualit."[1].
The Malcolm Baldrige Health Care version of the Criteria for Performance Excellence (HCPE) award has been created to foster a culture of quality improvement across an organization. Two studies of the impact of the award have found:
- "No significant difference in process of care results or outcomes between Baldrige recipients and their competitors, there was a significant difference in patient experience results" [2].
- "Slight enhancements in clinical outcomes, while hospital financial and efficiency measures all showed overwhelmingly positive operating results"[3]
Wennberg's classification framework can categorize causes of unwarranted variation[4].
Lean Sigma
Lean sigma combines approaches[5].
Measuring quality
Quality measures and their benchmarks are available form several organizations including:
- CQI Resource Center (coordinated by the Centers for Medicare & Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC); U.S. Department of Health and Human Services)
Why quality improvement efforts succeed and fail
Various organizational characteristics, some based on complexity science[6][7], may predict why quality improvement projects succeed[8][9][9][10] and fail[11][12].[13]
Studies using appreciative inquiry have been done.[11][14]
Different approaches may be needed depending on the level of certainty in the clinical science behind a quality improvement project.[15]
References
- ↑ Anonymous (2024), Quality improvement (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Schulingkamp, R. C., & Latham, J. R. (2015). Health Care Performance Excellence: A Comparison of Baldrige Award Recipients and Competitors.
- ↑ Unger, K. L. (2013). An investigation into the effects of winning the Malcolm Baldrige National Quality Award on the performance of hospitals/healthcare systems (Doctoral dissertation, Colorado State University).
- ↑ Harrison R, Manias E, Mears S, Heslop D, Hinchcliff R, Hay L (2018). "Addressing unwarranted clinical variation: A rapid review of current evidence". J Eval Clin Pract. doi:10.1111/jep.12930. PMID 29766616.
- ↑ Danese, P., Manfè, V. and Romano, P. (2017), A Systematic Literature Review on Recent Lean Research: State-of-the-art and Future Directions. International Journal of Management Reviews. doi:10.1111/ijmr.12156
- ↑ Massoud MR, Barry D, Murphy A, Albrecht Y, Sax S, Parchman M (2016). "How do we learn about improving health care: a call for a new epistemological paradigm". Int J Qual Health Care. 28 (3): 420–4. doi:10.1093/intqhc/mzw039. PMC 4931911. PMID 27118664.
- ↑ Jordon M, Lanham HJ, Anderson RA, McDaniel RR (2010). "Implications of complex adaptive systems theory for interpreting research about health care organizations". J Eval Clin Pract. 16 (1): 228–31. doi:10.1111/j.1365-2753.2009.01359.x. PMC 3667707. PMID 20367840.
- ↑ Leykum LK, Pugh J, Lawrence V, Parchman M, Noël PH, Cornell J; et al. (2007). "Organizational interventions employing principles of complexity science have improved outcomes for patients with Type II diabetes". Implement Sci. 2: 28. doi:10.1186/1748-5908-2-28. PMC 2018702. PMID 17725834.
- ↑ 9.0 9.1 Leykum LK, Parchman M, Pugh J, Lawrence V, Noël PH, McDaniel RR (2010). "The importance of organizational characteristics for improving outcomes in patients with chronic disease: a systematic review of congestive heart failure". Implement Sci. 5: 66. doi:10.1186/1748-5908-5-66. PMC 2936445. PMID 20735859.
- ↑ Lanham HJ, Leykum LK, Taylor BS, McCannon CJ, Lindberg C, Lester RT (2013). "How complexity science can inform scale-up and spread in health care: understanding the role of self-organization in variation across local contexts". Soc Sci Med. 93: 194–202. doi:10.1016/j.socscimed.2012.05.040. PMID 22819737.
- ↑ 11.0 11.1 Ruhe MC, Bobiak SN, Litaker D, Carter CA, Wu L, Schroeder C; et al. (2011). "Appreciative Inquiry for quality improvement in primary care practices". Qual Manag Health Care. 20 (1): 37–48. doi:10.1097/QMH.0b013e31820311be. PMC 4222905. PMID 21192206.
- ↑ Arar NH, Noel PH, Leykum L, Zeber JE, Romero R, Parchman ML (2011). "Implementing quality improvement in small, autonomous primary care practices: implications for the patient-centred medical home". Qual Prim Care. 19 (5): 289–300. PMC 3313551. PMID 22186171.
- ↑ Michel, P., et al. "What are the Barriers and Facilitators to the Implementation and/or Success of Quality Improvement and Risk Management in Hospitals: A Systematic Literature Review." J Epidemiol Public Health Rev 1.4 (2016).
- ↑ Peelle, Henry E. (2006). "Appreciative Inquiry and Creative Problem Solving in Cross-Functional Teams". The Journal of Applied Behavioral Science. SAGE Publications. 42 (4): 447–467. doi:10.1177/0021886306292479. ISSN 0021-8863.
- ↑ Leykum LK, Lanham HJ, Pugh JA, Parchman M, Anderson RA, Crabtree BF; et al. (2014). "Manifestations and implications of uncertainty for improving healthcare systems: an analysis of observational and interventional studies grounded in complexity science". Implement Sci. 9: 165. doi:10.1186/s13012-014-0165-1. PMC 4239371. PMID 25407138.