Friday, December 30, 2005

Health Serv Res - Physician Visits, Hospitalizations, and Socioeconomic Status

Ambulatory Care Sensitive Conditions in a Canadian Setting
Leslie L. Roos, Randy Walld, Julia Uhanova, Ruth Bond
Health Serv Res. 2005 Aug;40(4):1167-8

The persistent challenge of avoidable hospitalizations.
Clancy CM
Health Serv Res. 2005 Aug;40(4):953-6

Thursday, December 29, 2005

AHRQ - Chronic Condition Indicator

The Chronic Condition Indicator is one in a family of databases and software tools developed as part of the Healthcare Cost and Utilization Project (HCUP), it provides an easy way for users to categorize ICD-9-CM diagnosis codes as either "chronic" or "not chronic."

The Chronic Condition Indicator is created to facilitate health services research on diagnoses using administrative data. This classification system allows researchers to readily determine if a diagnosis is a chronic condition. In addition, the tool groups all diagnoses into body systems so that users can create indicators listing which specific body systems are affected by a chronic condition.

Chronic Condition Indicator

Wednesday, December 28, 2005

Am J Med Qual - Relationship between performance measurement and accreditation

implications for quality of care and patient safety
Miller MR, Pronovost P, Donithan M, Zeger S, Zhan C, Morlock L, Meyer GS Am J Med Qual. 2005 Sep-Oct;20(5):239-52.
[Abstract] [PDF] [References]

Am J Med Qual -Training Health Care Professionals for Patient Safety

American Journal of Medical Quality 2005 20: 277-279.
Carolyn M. Clancy
[PDF] [References]

Tuesday, December 27, 2005

Ann Intern Med - Hospital at Home

Feasibility and Outcomes of a Program To Provide Hospital-Level Care at Home for Acutely Ill Older Patients
Bruce Leff, Lynda Burton, Scott L. Mader, Bruce Naughton, Jeffrey Burl, Sharon K. Inouye, William B. Greenough, III, Susan Guido, Christopher Langston, Kevin D. Frick, Donald Steinwachs, and John R. Burton
Ann Intern Med. 2005 Dec 6;143(11):798-808
Abstract Full Text PDF

Hospital at Home: The Evidence Is Not Compelling
Sasha Shepperd
Ann Intern Med. 2005 Dec 6;143(11):840-1
Full Text PDF

Monday, December 26, 2005

NASHP - Maximizing the Use of State Adverse Event Data to Improve Patient Safety

During the nearly six years since the Institute of Medicine released its first report on medical errors, there has been growing recognition of the size and scope of the problem.
Many US states have responded by creating or improving reporting systems for collecting hospital-based adverse events. As of September 2005, twenty-four states had passed legislation or regulation related to hospital reporting of adverse events.

In May 2005, National Academy for State Health Policy (NASHP) convened a meeting of data collectors, analysts, and users to identify mechanisms to improve reporting, tools used for event report analysis and dissemination, and opportunities for improvement.
This report reviews key findings from the meeting to assist states in improving their reporting systems and to encourage providers to improve the quality of the required reports so that data are credible and useful in shaping patient safety improvement interventions.

Full text

Friday, December 23, 2005

saferhealthcare - Out of the Shadows

Raising the Profile of healthcare associated infections (HCAI) - 14 December 2005
Brian Duerden

Int J Qual Health Care - Economic modeling of methods to stimulate quality improvement

Karen Eggleston
Int J Qual Health Care 2005 17: 521-531
[Abstract] [Full Text] [PDF]

Thursday, December 22, 2005

Qual Saf Health Care - Narrative methods in quality improvement research

T Greenhalgh, J Russell and D Swinglehurst
Qual Saf Health Care 2005; 14: 443-449
[Abstract] [Full text] [PDF]

Int J Qual Health Care - Policymaker use of quality of care information

Jacqueline J. Fickel and Carol R. Thrush
Int J Qual Health Care 2005 17: 497-504
[Abstract] [Full Text] [PDF]

Wednesday, December 21, 2005

Pediatrics - Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system

Han YY, Carcillo JA, Venkataraman ST, et al.
Pediatrics. 2005;116:1506-1512.

Int J Qual Health Care - A performance assessment framework for hospitals

the WHO regional office for Europe PATH project
J. Veillard, F. Champagne, N. Klazinga, V. Kazandjian, O. A. Arah, and A.-L. Guisset
Int J Qual Health Care 2005 17: 487-496
[Abstract] [Full Text] [PDF]

Monday, December 19, 2005

Qual Saf Health Care - Control, compare and communicate

designing control charts to summarise efficiently data from multiple quality indicators
B Guthrie, T Love, T Fahey, A Morris, and F Sullivan
Qual Saf Health Care 2005; 14: 450-454
[Abstract] [Full text] [Web-only figures] [PDF]

Int J Qual Health Care - Patient perspectives of patient–provider communication after adverse events

Christine W. Duclos, Mary Eichler, Leslie Taylor, Javan Quintela, Deborah S. Main, Wilson Pace, and Elizabeth W. Staton
Int J Qual Health Care 2005 17: 479-486
[Abstract] [Full Text] [PDF]

Friday, December 16, 2005

Health Affairs - Blind faith and choice

Edwards RT
Health Affairs, Vol 24, Issue 6, 1624-1628
full text

J Gen Intern Med - What can hospitalized patients tell us about adverse events?

Learning from patient-reported incidents.
Weingart SN, Pagovich O, Sands DZ, et al.
J Gen Intern Med 2005 Sep; 20(9):830-836.

Thursday, December 15, 2005

ACSQ - Australian Council for Safety and Quality in Health Care Annual Report 2005

This sixth report is the last formal report to Health Ministers as the Australian Council for Safety and Quality in Health Care’s (Council) agreed extended term will finish in June 2006. It is set against a background of the Ministerial Review of future governance arrangements for safety and quality in health care.

This report builds on all five previous reports to Australian Health Ministers, provides a summary of achievements since Council’s inception in 2000 and identifies the foundation for future directions in safety and quality in Australia that has been built with the active support of many stakeholders.

final report

Australian Health Ministers Agree on New Safety and Quality Measures

Ministers agreed that the Australian Council for Safety and Quality in Health Care, which was established in January 2000, will be succeeded by a national body called the Australian Commission on Safety and Quality in Health Care which will report to Health Ministers and be closely linked to health departments and other government and non-government health bodies.

Ministers agreed with the Review finding (see previous news) that it was crucial that the state of safety and quality in the Australian health care system be regularly measured and reported publicly, and a new Australian Commission on Safety and Quality in Health Care would be charged with publishing a national report every two years.

read more

Wednesday, December 14, 2005

JAMA - The Long Road to Patient Safety

A Status Report on Patient Safety Systems
Daniel R. Longo; John E. Hewett; Bin Ge; Shari Schubert
JAMA. 2005;294:2858-2865.

Creating a Safer Health Care System: Finding the Constraint
Stephen G. Pauker; Ellen M. Zane; Deeb N. Salem
JAMA. 2005;294:2906-2908.

Tuesday, December 13, 2005

IOM - Performance Measurement: Accelerating Improvement

This is the first report in the Institute of Medicine (IOM) Pathways to Quality Health Care series, each report will be focused on a specific policy approach to improving the quality of health care.

This report focuses on the selection of measures to support the quality improvement efforts of a diverse set of stakeholders, and on the creation of a common infrastructure for guiding and managing aconsistent set of such measures nationally and regionally.

Monday, December 12, 2005

WHO - Draft Guidelines for Adverse Event Reporting and Learning Systems

World Health Organisation - World Alliance for Patient Safety is launching the new Draft Guidelines for Adverse Event Reporting and Learning Systems. The guidelines are being made available worldwide to facilitate the development of new and improved reporting systems for patient safety .

The primary importance of reporting systems is to learn from experience and mistakes, and to use these results as a basis for implementing preventive action in the future. The Alliance efforts in this area facilitate the compilation and interpretation of international data on adverse events for early detection of potential problems and sharing of results to ensure that solutions are developed.

The draft guidelines aim to support countries to select, adapt or modify the recommendations to improve their reporting. The guidelines will undergo modification over time as experiences accumulate.

More information [pdf 1.20Mb]

Friday, December 09, 2005

Department of Health - Surveillance of surgical site infection in orthopaedic surgery

Surveillance of surgical site infection following orthopaedic surgery has been included in the mandatory healthcare-associated infection surveillance system in England since April 2004.

The surveillance is managed by the Health Protection Agency on behalf of the Department of Health. Data is collected as part of the Surgical Site Infection Surveillance Service (SSISS), which has supported voluntary surveillance in several categories of surgical procedure since 1997.

Surgical Site Infection Surveillance Service (SSISS) has recently published the first annual report:

Mandatory surveillance of surgical site infection in orthopaedic surgery, report of data collected between April 2004 and March 2005

Thursday, December 08, 2005

JAMA - Clinical Decision Support and Appropriateness of Antimicrobial Prescribing

A Randomized Trial
Matthew H. Samore, Kim Bateman, Stephen C. Alder, Elizabeth Hannah, Sharon Donnelly, Gregory J. Stoddard, Bassam Haddadin, Michael A. Rubin, Jacquelyn Williamson, Barry Stults, Randall Rupper, and Kurt Stevenson
JAMA. 2005;294:2305-2314.


The Institute of Healthcare Improvement has partnered with JAMA, with the help of The Robert Wood Johnson Foundation, to facilitate the transition of science into practice through the series “Author in the Room."

In this series, the author of a study published in JAMA with the potential to change clinical practice will talk with clinicians during a conference call, facilitated by clinical experts in implementing changes in practice.

Read the editorial (DeAngelis, C., MD, MPH, Berwick, D., MP, MPP. JAMA. 2005;293:1004.)

Wednesday, December 21, 2005 Author in the Room teleconference deal with Matthew H. Samore, MD, author of "Clinical Decision Support and Appropriateness of Antimicrobial Prescribing."
Author in the RoomSM

Wednesday, December 07, 2005

NQF - Voluntary Consensus Standards for Diabetes Quality Improvement

The National Quality Forum (NQF) has announced the endorsement of 29 national voluntary consensus standards for diabetes care for internal quality improvement (QI) and community-level monitoring.

The purpose of these NQF-endorsed™ measures is to improve the care of adults who have diabetes mellitus. The standards are derived from a larger set of measures advocated by the National Diabetes Quality Improvement Alliance or measures developed by the Agency for Healthcare Research and Quality.

Tuesday, December 06, 2005

Medical Care - How Robust Are Hospital Ranks Based on Composite Performance Measures?

Rowena Jacobs, Maria Goddard, Peter C. Smith
Medical Care. 43(12):1177-1184
Abstract HTML PDF (343 K)

AHRQ - QI Workgroup on Composite Measures

Call for Nominations

The Agency for Healthcare Research and Quality (AHRQ) is seeking nominations for members of the AHRQ Quality Indicators Workgroup on Composite Measures for the Prevention Quality Indicators (PQIs).

The AHRQ QI Workgroup is being formed as part of a structured approach for developing composite measures at the national and state level.

The Workgroups will evaluate appropriate technical and feasible methodological approaches currently available.

Their role will be to discuss and suggest strategies as to what composite measure methodology would best fit the AHRQ QI user needs.


Monday, December 05, 2005

WHO/Europe – Do current discharge arrangements from inpatient hospital care

for the elderly reduce readmission rates, the length of inpatient stay or mortality, or improve health status?

For many older people, admission to an acute hospital is associated with a decline in physical functioning, which is not always recovered at the time of discharge, or even soon.

Iatrogenic deterioration is not uncommon and, with extended stays, both informal and formal patterns of support at home may be disrupted and make a return to independent living extremely difficult.

Thus, hospital discharge arrangements are a key issue in ensuring the safe and effective transfer of older people between inpatient hospital care, and community-based home care.

A Health Evidence Network (HEN) evidence report shows that it is possible to reduce the rate of hospital readmission of elderly people.


Friday, December 02, 2005

PBGH - Reports on Physician Performance Measurement and Incentives

The Pacific Business Group on Health (PBGH), a business coalition of 50 purchasers, recently released two reports:

" Using Administrative Data to Assess Physician Quality and Efficiency " outlines quality measures that address structure, process, and outcome metrics currently in use. Commercially available cost efficiency software measures relative use of resources after defining episodes of care, considering attribution, and adjusting for risk. The report describes an array of national initiatives engaged in the development, endorsement, or deployment of standardized measurement.

"Aligning Physician Incentives" documents agreement by a diverse group of stakeholders to endorse performance-based payment of physicians.

Thursday, December 01, 2005

BMJ - Why doctors' outcomes should be published in the press

Ben Bridgewater
BMJ 2005;331:1210
[Extract] [Full text]

see also:

Dying to Know: Public Release of Information About Quality of Health Care
Martin N. Marshall, Paul G. Shekelle, Robert H. Brook, Sheila Leatherman
2000 - The Nuffield Trust – RAND Health