The Joint Commission journal on quality improvement最新文献

{"title":"Assessing Consumer Perceptions of Inpatient Psychiatric Treatment: The Perceptions of Care Survey","authors":"Susan V. Eisen PhD,&nbsp;Marsha Wilcox EdD, ScD (Research Fellow),&nbsp;Thomas Idiculla MSW,&nbsp;Alexander Speredelozzi MBA (Manager),&nbsp;Barbara Dickey PhD (Associate Professor)","doi":"10.1016/S1070-3241(02)28056-6","DOIUrl":"10.1016/S1070-3241(02)28056-6","url":null,"abstract":"<div><h3>Background</h3><p>Consumer perceptions of behavioral health care are widely recognized as important quality indicators. This article reports the development and use of the Perceptions of Care (PoC) survey, a standardized public domain measure of consumer perceptions of the quality of inpatient mental health or substance abuse care. The goals were to develop a low-cost, low-burden survey that would address important quality domains, allow for interprogram comparisons and national benchmarks, be useful for quality improvement purposes, and meet accreditation and payer requirements.</p></div><div><h3>Methods</h3><p>The sample was composed of 6,972 patients treated in 14 inpatient behavioral health or substance abuse treatment programs. The PoC survey was given to patients by program staff in the 24-hour period before discharge.</p></div><div><h3>Results</h3><p>Aggregate reports and ratings of care identified areas that are highly evaluated by consumers, as well as areas that provide opportunities for quality improvement. Factor analysis identified four domains of care, and a 100-point score was developed for each domain. Regression analyses identified significant predictors of perceptions of care for use in computing risk-adjusted scores. Unadjusted and adjusted scores were presented to demonstrate the impact of risk adjustment on quality of care scores and relative ranking of programs. Examples were given of how programs used survey results to improve the quality of care.</p></div><div><h3>Discussion</h3><p>Results demonstrated that the PoC survey is sensitive to detecting differences among inpatient behavioral health programs and can be useful in guiding quality improvement efforts. However, risk adjustment is important for appropriate interpretation of results.</p></div>","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 9","pages":"Pages 510-526"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28056-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21978012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor’s Note","authors":"Steven Berman","doi":"10.1016/S1070-3241(02)28050-5","DOIUrl":"https://doi.org/10.1016/S1070-3241(02)28050-5","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 9","pages":"Page 471"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28050-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91686325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsystem Management as a Promising New Methodology for Improving the Cost and Quality of Health Care","authors":"James Brian Quinn PhD (Buchanan Professor of Management)","doi":"10.1016/S1070-3241(02)28053-0","DOIUrl":"10.1016/S1070-3241(02)28053-0","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 9","pages":"Pages 495-496"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28053-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21978009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Senior Leaders’ Role in Improving the Performance of the Front-Line Delivery Units","authors":"Joan Marren MEd, MA, RN (Chief Operating Officer),&nbsp;Ann Marie R. Hess MSN, MS (External Consultant)","doi":"10.1016/S1070-3241(02)28054-2","DOIUrl":"10.1016/S1070-3241(02)28054-2","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 9","pages":"Pages 496-497"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28054-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21978010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rapid Interview Protocol Supporting Patient-Centered Quality Improvement: Hearing the Parent’s Voice in a Pediatric Cancer Unit","authors":"Elisa J. Sobo PhD (Research Scientist),&nbsp;Glenn Billman MD (Medical Safety Officer),&nbsp;Lillian Lim MPH (Health Educator),&nbsp;J. Wilken Murdock (Intern),&nbsp;Elvia Romero (Research Assistant),&nbsp;Donna Donoghue RN (Director),&nbsp;William Roberts MD (Medical Director),&nbsp;Paul S. Kurtin MD","doi":"10.1016/S1070-3241(02)28055-4","DOIUrl":"10.1016/S1070-3241(02)28055-4","url":null,"abstract":"<div><h3>Background</h3><p>The Institute of Medicine’s 2001 report on quality delimits six dimensions of optimal care: safety, effectiveness, efficiency, timeliness, patient centeredness, and equity. In fall 2001 parents of pediatric cancer patients were interviewed to determine how well they thought these dimensions were addressed with respect to medication administration. Immediate goals were to identify system weaknesses and devise strategies to prevent future errors. A higherorder goal was to develop and demonstrate a model protocol for rapid-cycle interview assessments.</p></div><div><h3>Methods</h3><p>Hematology/oncology directors worked with a research expert to develop a semistructured interview protocol. After training, which included directed reading, oral instruction, and role-playing, a convenience sample of 20 English- and Spanish-speaking parents of inpatients was recruited. Parents were asked to characterize current medication administration practices and to describe problems that they had experienced or witnessed. Rapid content analysis techniques were used to identify issues of importance to the parents.</p></div><div><h3>Findings</h3><p>Parents’ medication concerns centered on their children’s comfort. Parents called for communication improvements, standardization of all nursing procedures and techniques, and a guide or an outline providing a clear understanding of what to expect when and from whom. Viewing these concerns in relation to the Institute of Medicine’s quality domains allowed the department to frame an improvement action plan aligned with organizational and national priorities.</p></div><div><h3>Implications</h3><p>With good supervision and limited focused training, inexperienced staff can successfully administer semistructured qualitative interviews and help analyze findings for rapid cycle improvement purposes. The protocol can be adapted for use in organizations interested in rapid qualitative assessments of patient and parent preferences.</p></div>","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 9","pages":"Pages 498-509"},"PeriodicalIF":0.0,"publicationDate":"2002-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28055-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21978011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Quality Improvement Research","authors":"Judith E. Frank MD, MS (Co-Director),&nbsp;Tricia Mitchell Kim MBA (Research Coordinator),&nbsp;Eugene C. Nelson DSc, MPH (Co-Director)","doi":"10.1016/S1070-3241(02)28045-1","DOIUrl":"10.1016/S1070-3241(02)28045-1","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 8","pages":"Pages 451-452"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28045-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56462179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need for Education in Quality Improvement and Evidence-Based Practice","authors":"Jennifer E. Slepin RN","doi":"10.1016/S1070-3241(02)28049-9","DOIUrl":"10.1016/S1070-3241(02)28049-9","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 8","pages":"Pages 463-464"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28049-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56462233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Sexual Activity Defined in the HEDIS Measure of Screening Young Women for Chlamydia trachomatis","authors":"Guoyu Tao PhD (Health Scientist),&nbsp;Cathleen M. Walsh DrPH (Senior Health Scientist),&nbsp;Lynda A. Anderson PhD (Behavior Scientist),&nbsp;Kathleen L. Irwin MD, MPH (Medical Epidemiologist and Chief)","doi":"10.1016/S1070-3241(02)28043-8","DOIUrl":"10.1016/S1070-3241(02)28043-8","url":null,"abstract":"<div><h3>Background</h3><p>Periodic screening of sexually active young women for <em>Chlamydia trachomatis</em> is widely recommended and is now monitored in the Health Plan Employer Data and Information Set (HEDIS). Because little is known about how well the HEDIS measure identifies sexually active women eligible for screening, rates of sexual activity as defined by the measure’s specifications were compared with those derived from self-reported sexual behavior and use of sexual health services among privately insured women.</p></div><div><h3>Methods</h3><p>Using the 1996 MarketScan claims data for privately insured women aged 15–25 years, a measure of sexual activity based on the HEDIS specifications for sexual activity was calculated, that is, claims for Pap tests and pelvic examinations, contraceptive services, pregnancy-related services, and screening and treatment for sexually transmitted diseases.</p></div><div><h3>Results</h3><p>For privately insured women 15–25 years of age, the sexual activity rate was estimated to be 27% based on the HEDIS algorithm using the MarketScan claims data and 60% based on self-reported sexual behavior or 62% based on self-reported use of sexual health services using the 1995 National Survey of Family Growth (NSFG) data.</p></div><div><h3>Discussion</h3><p>Among young, privately insured women, use of claims specified by HEDIS classifies a smaller proportion of young women as sexually active than does use of self-reported survey data on sexual behavior or use of sexual health services. If HEDIS continues to rely on claims data because it is easier or less costly to collect and analyze than survey data, users of this performance measure should be aware that it may underestimate the number of women who are eligible for this screening benefit.</p></div>","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 8","pages":"Pages 435-440"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28043-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56462148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Trial of Three Diabetes Registry Implementation Strategies in a Community Internal Medicine Practice","authors":"Robert J. Stroebel MD (Consultant),&nbsp;Sidna M. Scheitel MD, MPH (Consultant),&nbsp;John S. Fitz MD (Consultant),&nbsp;Ruth A. Herman BSN (RN Disease Management Strategies Coordinator),&nbsp;James M. Naessens MPH (Statistician),&nbsp;Christopher G. Scott MS (Statistician),&nbsp;David A. Zill BS (Computer Programmer),&nbsp;Lisa Muller BA (Computer Programmer)","doi":"10.1016/S1070-3241(02)28044-X","DOIUrl":"10.1016/S1070-3241(02)28044-X","url":null,"abstract":"<div><h3>Background</h3><p>Disease registries are powerful tools with the potential to transform the way chronic diseases are managed. To date, however, little work has been done to determine how to optimize the implementation of a chronic disease registry in practice.</p></div><div><h3>Methods</h3><p>Twenty-nine physicians and their nurse teams in a large community internal medicine practice participated in this 6-month prospective randomized trial in 2000. Teams were assigned to one of three implementation strategies using information from a diabetes registry. Process and outcome measures for diabetes management were analyzed. Process measures included the percentage of patients completing glycosylated hemoglobin (Hgb) testing within 6 months and low-density lipoprotein (LDL) testing within 12 months. Outcome measures included the percentage of patients with a glycosylated Hgb &gt; 9.3% (equivalent to a HgbA1c &gt; 8.0%), the percentage of patients with an LDL cholesterol &gt; 130<!--> <!-->mg/dl, and the percentage of patients with controlled blood pressure, defined as &lt; 130/85 millimeters of mercury. Mean change in LDL and glycosylated Hgb values was also measured.</p></div><div><h3>Results</h3><p>Teams randomized to an intervention strategy that included direct letters to patients showed significant improvement across a number of measures. The improvement was most apparent among patients without recent testing or with poorly controlled disease. The two interventions that did not include direct patient letters resulted in limited improvement.</p></div><div><h3>Discussion</h3><p>Disease registries can be used to improve outcomes in the management of diabetes and other chronic diseases. Better outcomes were seen in patients who received letters based on registrygenerated data. This strategy should be included as part of a comprehensive chronic disease management plan. Further refinements in the use of registries should result in further incremental improvement.</p></div>","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 8","pages":"Pages 441-450"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28044-X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56462162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr Weeks replies","authors":"William B. Weeks MD, MBA","doi":"10.1016/S1070-3241(02)28048-7","DOIUrl":"10.1016/S1070-3241(02)28048-7","url":null,"abstract":"","PeriodicalId":79382,"journal":{"name":"The Joint Commission journal on quality improvement","volume":"28 8","pages":"Pages 462-463"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1070-3241(02)28048-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56462220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}