Monday, October 31, 2005

NICE/HDA - Annual Report 2004-2005

The National Institute for Health and Clinical Excellence (NICE) was formed on 1 April 2005, when the National Institute for Clinical Excellence took on the functions of the Health Development Agency to create a single excellence-in-practice organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.

Currently NICE produces guidance in three areas of health:

  • Technology appraisals - guidance on the use of new and existing medicines and treatments within the NHS in England and Wales.
  • Clinical guidelines - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS in England and Wales.
  • Interventional procedures - guidance on whether interventional procedures used for diagnosis or treatment are safe enough and work well enough for routine use in England, Wales and Scotland.

The annual report and its accompanying accounts cover the activities of both NICE and the Health Development Agency (HDA) during 2004/5.

NICE/HDA Annual Report 2004-2005 (pdf 3.4 MB)

Friday, October 28, 2005

Am Heart Hosp J - Electronic health record systems

The vehicle for implementing performance measures
O'Toole, M., Kmetik, K., Bossley, H., and others.
American Heart Hospital Journal 3, pp. 88-93

Cancer - Clinical impact and frequency of anatomic pathology errors in cancer diagnoses

Raab SS, Grzybicki DM, Janosky JE, Zarbo RJ, Meier FA, Jensen C, Geyer SJ.
Cancer. 2005 Published Online: 10 Oct 2005

Thursday, October 27, 2005

Qual Saf Health Care - Toward stronger evidence on quality improvement

Draft publication guidelines: the beginning of a consensus project
F Davidoff and P Batalden
Qual Saf Health Care 2005; 14: 319-325.
[Abstract] [Full text] [PDF]


Why new guidelines for reporting improvement research? And why now?
D P Stevens
Qual Saf Health Care 2005;
[Extract] [Full text] [PDF]


Broadening the view of evidence-based medicine
D M Berwick
Qual Saf Health Care 2005; 14: 315-316.
[Extract] [Full text] [PDF]

Consensus publication guidelines: the next step in the science of quality improvement?
R G Thomson
Qual Saf Health Care 2005; 14: 317-318.
[Extract] [Full text] [PDF]

Wednesday, October 26, 2005

AHA - Forward Momentum

Hospital Use of Information Technology
American Hospital Association - October 2005

While 9 out of 10 hospitals are using or considering adopting health information technology (IT) for clinical uses, most hospitals, especially small or rural hospitals, cite cost as a considerable barrier to broader implementation, according to a new study released by the American Hospital Association (AHA).

The results from more than 900 hospitals show that IT use falls along a broad spectrum, ranging from hospitals just getting started to hospitals using sophisticated IT systems.

While most are still in the beginning stages, the survey shows hospitals are making investments in IT, in large part, to make gains in the safety and quality of patient care. Some of the technologies and systems hospitals are using include bar coding devices, computerized physician order entry and electronic health records (EHR).

Press Release


Tuesday, October 25, 2005

RAND - Research on Health Information Technology

RAND researchers have estimated the potential costs and benefits of widespread adoption of Health Information Technology (HIT). The team also has identified the actions needed to turn potential benefits into actual benefits.

a selection of RAND Health's recent research on HIT

Monday, October 24, 2005

NCQA - State of Health Care Quality report 2005

Health care quality improved markedly in many key areas in 2004, but only about 21.5% of the industry now reports publicly on its performance, according to National Committee for Quality Assurance (NCQA)’s annual State of Health Care Quality report.

Quick Facts
Webcast (Windows Media)

U.S. News and World Report used the NCQA study as the basis of a new magazine feature called "America's Best Health Plans"

The U.S. News feature is available online
U.S. News and World Report/NCQA Ranking methodology

Friday, October 21, 2005

David A. Winston Health Policy Lecture - Health Care Quality

From Theory to Practice

The Seventh Annual David A. Winston Health Policy Lecture sponsored by the Federation of American Hospitals provides an overview of various efforts to improve patient safety and healthcare quality, and discusses the importance of unifying these efforts to achieve standardized mechanisms for measurement, accountability and consumer reporting.

A webcast of this event is available from

Presentation Slides (.pdf)

Thursday, October 20, 2005

NQMC - Features Patient Safety-Related Measures

More than 40 of the approximately 700 quality measures included in the National Quality Measures Clearinghouse (NQMC) have been categorized in the Institute of Medicine's domain of "safety".

The NQMC team classifies a measure as patient safety-related when safety applies to the measure's primary clinical component.

To find these safety-related evidence-based measures, use the detailed search feature at (scroll approximately two-thirds down, select "safety" in the IOM Domain field box, scroll to the bottom of page, and select Search).

Wednesday, October 19, 2005

WHO - Clean Care is Safer Care

Health care-associated infection is a major issue in patient safety as it affects millions of people worldwide and complicates the delivery of patient care. Infections contribute to patient deaths and disability, promote resistance to antibiotics and generate additional expenditure to those already incurred by the patients' underlying disease.

The World Alliance for Patient Safety addresses the problem of health care-associated infection through the Global Patient Safety Challenge programme with the theme "Clean Care is Safer Care".

Hand hygiene, a very simple action, remains the primary measure to reduce health careassociated infection and the spread of antimicrobial resistance, enhancing safety of care across all settings, from advanced health care establishments to community health posts across countries.

The new World Health Organization (WHO) Guidelines on Hand Hygiene in Health Care are being developed in collaboration with experts from research and academic institutions worldwideand technical experts from WHO.


Clean Care is Safer Care: a worldwide priority
Pittet D, Donaldson L
The Lancet, Volume 366, Number 9493, 8 October 2005 pages 1246-1247
Full Text

Tuesday, October 18, 2005

AHA - The Costs of Caring

Sources of Growth in Spending for Hospital Care
American Hospital Association - August 2005

Greater demand for hospital care, more complex treatments and the continued workforce shortage are major factors behind the growth in spending on hospital care from 1998 to 2003, according to a new report released by the American Hospital Association (AHA).

Of the increase in spending on hospital care from 1998 to 2003:

  • 52 percent is due to rising costs for the goods and services hospitals purchase to provide care. Rising wages and salaries account for three quarters of this increase as hospitals face a growing workforce shortage.

  • 43 percent is due to higher demand for care. The population is growing and aging and on average, each person is using more hospital services.

  • 5 percent is due to increased intensity of care provided. Hospital care is more complex due to both changes in demographics (older, frailer patients) and changes in technology (more sophisticated treatment options).

Press Release



Monday, October 17, 2005

AAFP - Pay-For-Performance statement

"...Both public and private health insurers, as well as employers, have come to recognize the importance of experimentation with physician payment methodologies that incentivize medical practices to expand the provision of preventive services, improve clinical outcomes and enhance patient safety and satisfaction with the care they receive.

These incentive programs, known collectively as “pay for performance” programs, have the potential to increase physician use of electronic health information technology, evidence-based clinical guidelines, administrative and clinical “best practices” and access to appropriate and timely care.

The American Academy of Family Physicians (AAFP) will use its influence to support and encourage pay for performance experimentation using the following guidelines "

Friday, October 14, 2005

JAMA - Early Experience with Pay-for-Performance

From Concept to Practice
Meredith B. Rosenthal; Richard G. Frank; Zhonghe Li; Arnold M. Epstein
JAMA. 2005;294:1788-1793.

Pay-for-Performance Research: How to Learn What Clinicians and Policy Makers Need to Know
R. Adams Dudley
JAMA. 2005;294:1821-1823.

Related Commonwealth Fund press release

Thursday, October 13, 2005

AHRQ - Quality Indicators User Meeting

September 26-27, 2005
AHRQ Conference Center – Rockville Maryland

The two-day User Meeting was intended both for active users of the AHRQ Quality Indicators (AHRQ QI) and for those interested in how the AHRQ QI might be used in their organizations.

The sessions focused on lessons learned from actual applications on these topics:

  • New Pediatric Indicator Module
  • Applying the AHRQ QI to improve population health
  • Using the AHRQ QI as a catalyst for quality improvement
  • Implications of ICD-9-CM coding practices
  • Use of the AHRQ QI in the National Healthcare Quality Reports
  • Methods for creating aggregate performance indices
  • Considerations in using the AHRQ QI for comparative reporting and pay-for-performance
presentations are now available

Wednesday, October 12, 2005

CMAJ - Improving patient safety

moving beyond the "hype" of medical errors
Alan J. Forster, Kaveh G. Shojania, and Carl van Walraven
CMAJ 2005 173: 893-894
[Full Text] [PDF]

Lancet - Personal digital assistants in health care

experienced clinicians in the palm of your hand?
Daniel C Baumgart
The Lancet 2005; 366:1210-1222
Summary Full Text

Tuesday, October 11, 2005

NEJM - Cost-Effectiveness in a Flat World

Can ICDs Help the United States Get Rhythm?
L. Goldman
N Engl J Med 2005 353: 1513-1515
Extract Full Text PDF

Medicare and Cost-Effectiveness Analysis
P. J. Neumann, A. B. Rosen, and M. C. Weinstein
N Engl J Med 2005 353: 1516-1522
Extract Full Text PDF

Cost-Effectiveness of Implantable Cardioverter–Defibrillators
G. D. Sanders, M. A. Hlatky, and D. K. Owens
N Engl J Med 2005 353: 1471-1480
Abstract Full Text PDF

Monday, October 10, 2005

IHI - Leadership Guide to Patient Safety

Resources and Tools for Establishing and Maintaining Patient Safety

Institute for Healthcare Improvement; 2005

Leadership is the critical element in a successful patient safety program. The unique role of leadership is to establish the value system in the organization, set strategic goals for activities to be undertaken, align efforts within the organization to achieve those goals, provide resources for the creation of effective systems, remove obstacles for clinicians and staff, and require adherence to known practices that will promote patient safety.

Eight steps to achieving patient safety and high reliability are presented in this guide.
View guide

Friday, October 07, 2005

Ministero della Salute - protocollo per il monitoraggio degli "eventi sentinella"

Il Ministero della Salute ha elaborato, in via sperimentale, un Protocollo per il monitoraggio degli eventi sentinella, con l’obiettivo di fornire alle Regioni e alle Aziende sanitarie una modalit√† univoca di sorveglianza e gestione di tali eventi.

Thursday, October 06, 2005

CMWF - A Need to Transform the U.S. Health Care System

Improving Access, Quality, and Efficiency
Anne Gauthier and Michelle Serber
The Commonwealth Fund, October 2005

Despite spending more per capita on health care than any other country, the U.S. health system is fraught with waste and inefficiency, according to a new chartbook released by the Commonwealth Fund Commission on a High Performance Health System.


Chartbook PDF (386K) [download]
Chartbook PowerPoint (1647K) [download]

webcast provided by

Commentary: "A Tale of Two Health Systems"
James J. Mongan, M.D.,
The Commonwealth Fund, October 2005

Wednesday, October 05, 2005

HCUP - Procedure Classes

Procedure Classes is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP). The Procedure Classes provide users an easy way to categorize procedure codes into one of four broad categories: Minor Diagnostic, Minor Therapeutic, Major Diagnostic, and Major Therapeutic. Procedure codes for this tool are based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), Fifth Edition.

The Procedure Classes are created to facilitate health services research on hospital procedures using administrative data. This classification system allows the researcher to readily determine if (a) a procedure is diagnostic or therapeutic, and (b) a procedure is minor or major in terms of invasiveness and/or resource use.

downloadable software

Tuesday, October 04, 2005

AHRQ – Effective Health Care Program

HHS’ Agency for Healthcare Research and Quality launched its new Effective Health Care Program to help clinicians and patients determine which drugs and other medical treatments work best for certain health conditions.

The new program includes three components:

Comparative Effectiveness Reports—The 13 existing Evidence-based Practice Centers (EPCs) will focus especially on comparing the relative effectiveness of different treatments.

Network of Research Centers—A new network of 13 Developing Evidence to Inform Decisions about Effectiveness research centers (referred to as DEcIDE) will carry out accelerated studies.

Making Findings Clear for Different Audiences—A new Clinical Decisions and Communications Science Center (Eisenberg Center) will translate findings in ways appropriate for the needs of the different stakeholders, including consumers, clinicians, payers, and health care policy makers

A new Web site for the program,, was also announced.