Tuesday, January 31, 2006

IOM - Valuing Health for Regulatory Cost-Effectiveness Analysis

This report from the Institute of Medicine (IOM) reviews and makes recommendations for using integrated measures of morbidity and mortality (such as quality-adjusted life years, or QALYs); reporting cost-effectiveness ratios; and data and research needs to improve regulatory cost-effectiveness analysis.
It also considers the ethical implications of using cost-effectiveness analysis, and integrated measures of health impact, in regulatory policy development.
www.iom.edu/CMS/3809/19739/32029.aspx

Monday, January 30, 2006

Int J Qual Health Care - Challenging the world: patient safety and health care-associated infection

Didier Pittet and Liam Donaldson
International Journal for Quality in Health Care 2006 18(1):4-8
[Abstract] [Full Text] [PDF]

editorial
A research agenda for patient safety
Thomas V. Perneger
Int J Qual Health Care 2006 18: 1-3
[Extract] [Full Text] [PDF]

Int J Qual Health Care - Use of risk-adjusted change in health status to assess the performance of integrated service networks in the Veterans Health

Selim AJ, Berlowitz D, Fincke G, Rogers W, Qian S, Lee A, Cong Z, Selim BJ, Ren XS, Rosen AK, Kazis LE.
International Journal for Quality in Health Care . 2006 Feb;18(1):43-50.
[Abstract] [Full Text] [PDF]

Friday, January 27, 2006

Medical Care - Readiness to Report Medical Treatment Errors

The Effects of Safety Procedures, Safety Information, and Priority of Safety.
Eitan Naveh, Tal Katz-Navon, Zvi Stern,
Medical Care. 44(2):117-123, February 2006.
Abstract HTML PDF

Medical Care - Comparison of Administrative Data and Medical Records to Measure the Quality of Medical Care Provided to Vulnerable Older Patients.

Catherine H. MacLean, Rachel Louie, Paul G. Shekelle, Carol P. Roth, Debra Saliba, Takahiro Higashi, John Adams, John T. Chang, Caren J. Kamberg, David H. Solomon, Roy T. Young, Neil S. Wenger
Medical Care. 44(2):141-148, February 2006.
Abstract HTML PDF

Thursday, January 26, 2006

IHI - Safety Climate Survey

Organizations working to develop or improve a culture of safety need a reliable measure to monitor the success of their initiatives.
The Institute for Healthcare Improvement (IHI) in collaboration with The Center of Excellence for Patient Safety Research & Practice at the University of Texas develop this survey tool to gain information about the perceptions of front-line clinical staff about safety in their clinical area.

Safety Climate Survey 2005 (IHI Tool)

Safety Climate Survey 2005 Benchmarking Data

Safety Climate Survey Calculation Spreadsheet 2005 (IHI Tool)

Wednesday, January 25, 2006

NPSA - Incident Decision Tree

The Incident Decision Tree is a key component of the National Patient Safety Agency’s (NPSA) drive to help the NHS move away from asking “Who was to blame?” to “Why did the individual act in this way?” when things go wrong.

The Incident Decision Tree has been created to help NHS managers and senior clinicians decide whether they need to suspend (exclude) staff involved in a serious patient safety incident and to identify appropriate management action.

The aim is to promote fair and consistent staff treatment within and between healthcare organisations.

The Incident Decision Tree complements the NPSA’s Root Cause Analysis toolkit and the two can be used in parallel.

Tuesday, January 24, 2006

NHS - Discharge from hospital pathway, process and practice

This learning material from the United Kingdom Department of Health's is designed to help senior staff and practitioners in acute hospitals and their partners in local authorities and primary care trusts to improve the discharge care pathway of adults who have complex discharge needs.

PDF HTML

Monday, January 23, 2006

JAMA - The 100 000 Lives Campaign

Setting a Goal and a Deadline for Improving Health Care Quality
Donald M. Berwick, MD, MPP, FRCP; David R. Calkins, MD, MPP; C. Joseph McCannon, BA; Andrew D. Hackbarth, BA
JAMA. 2006;295:324-327
PDF

Friday, January 20, 2006

Ann Fam Med - The break-even point

when medical advances are less important than improving the fidelity with which they are delivered
Woolf SH, Johnson RE.
Ann Fam Med. 2005 Nov-Dec;3(6):545-52
[Full Text] [PDF] [Supplemental data: Figure]

HSC - Can Money Buy Quality?

Physician Response to Pay for Performance

Thomas Bodenheimer, Jessica H. May, Robert A. Berenson, Jennifer Coughlan
Center for Studying Health System Change (HSC)
Issue Brief No. 102 , December 2005
pdf html

Thursday, January 19, 2006

AHRQ - The Hospital Built Environment

What Role Might Funders of Health Services Research Play?
AHRQ Publication No. 05-0106-EF, October 2005.
http://www.ahrq.gov/qual/hospbuilt/

A literature review and interviews with architects, designers, academics, and health care executives were conducted between February and May of 2005, in an attempt to determine if associations exist between hospital building design elements and patient and staff safety, health outcomes, and patient and staff satisfaction levels.

The findings were used to bring focus to the challenges of evidence-based hospital design and the roles that funders might play in the development and transfer of knowledge related to the constructed hospital environment.

pdf

Tuesday, January 17, 2006

BMJ - ABC of health informatics

Health and the future: promise or peril?
Jeremy C Wyatt and Frank Sullivane
BMJ, Dec 2005; 331: 1391 - 1393
Full text PDF

Communication and navigation around the healthcare system
Jeremy C Wyatt and Frank Sullivan
BMJ, Dec 2005; 331: 1325 - 1327
Full text PDF

Improving services with informatics tools
Frank Sullivan and Jeremy C Wyatt
BMJ, Nov 2005; 331: 1190 - 1192
Full text PDF

Keeping up: learning in the workplace
Jeremy C Wyatt and Frank Sullivan
BMJ, Nov 2005; 331: 1129 - 1132
Full text PDF

Referral or follow-up?
Frank Sullivan and Jeremy C Wyatt
BMJ, Nov 2005; 331: 1072 - 1074
Full text PDF

How computers help make efficient use of consultations
Frank Sullivan and Jeremy C Wyatt
BMJ, Oct 2005; 331: 1010 - 1012
Full text PDF

How informatics tools help deal with patients' problems
Frank Sullivan and Jeremy C Wyatt
BMJ, Oct 2005; 331: 955 - 957
Full text PDF

How computers can help to share understanding with patients
Frank Sullivan and Jeremy C Wyatt
BMJ, Oct 2005; 331: 892 - 894
Full text PDF

How decision support tools help define clinical problems
Frank Sullivan and Jeremy C Wyatt
BMJ, Oct 2005; 331: 831 - 833
Full text PDF

Why is this patient here today?
Frank Sullivan and Jeremy C Wyatt
BMJ, Sep 2005; 331: 678 - 680
Full text PDF

Is a consultation needed?
Frank Sullivan and Jeremy C Wyatt
BMJ, Sep 2005; 331: 625 - 627
Full text PDF

What is health information?
Jeremy C Wyatt and Frank Sullivan
BMJ, Sep 2005; 331: 566 - 568
Full text PDF

Monday, January 16, 2006

Health Affairs - U.S. Hospitals: Mission Vs. Market

January/February 2006 - Volume 25, Number 1

The new issue of Health Affairs focuses entirely on hospitals, including studies on quality, reporting, pay-for-performance and other new technology.

http://content.healthaffairs.org/content/vol25/issue1/

Friday, January 13, 2006

AHRQ - 2005 Annual Patient Safety and HIT Conference Proceedings

This document provides a synopsis of the major findings from the 2005 Patient Safety and Health IT Conference as well as lists of various tools and products developed.

For greater detail, including power point presentations and video recordings of select presentations go to: healthit.ahrq.gov/.../materials.html.

Download the conference proceedings (MS-Word, 536KB)

Thursday, January 12, 2006

AHRQ - A Toolkit for Redesign in Health Care

Agency for Healthcare Research and Quality
www.ahrq.gov/qual/toolkit/

This toolkit presents strategies for comprehensively redesigning and transforming processes of care in a hospital.
It includes a discussion of the forces that compel health care systems to embark on redesign or system transformation; a series of steps to be taken in planning for such as redesign or system transformation; and strategies for translating information gathered into proposed projects for implementation.

This toolkit was prepared for the Agency for Healthcare Research and Quality (AHRQ) by Denver Health, a partner in AHRQ's Integrated Delivery System Research Network.

Select for print version (PDF File, 350 KB).

Wednesday, January 11, 2006

AHRQ Releases 2005 National Healthcare Quality And Disparities Reports

Press Release, January 9, 2006.
Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/press/pr2005/nhqrdrpr.htm

These reports, issued annually, measure quality and disparities in four key areas of health care in U.S.: effectiveness, patient safety, timeliness, and patient centeredness.

The 2005 National Healthcare Quality Report finds that overall quality of care for all Americans improved at a rate of 2.8 percent, the same increase shown in last year's report. However, the report notes there has been much more rapid improvement in some measures, especially where there have been focused efforts to improve care.

The 2005 National Healthcare Disparities Report finds that many of the largest disparities in measures of quality and access are observed for low-income people regardless of race or ethnicity, with some signs of improvement.

Monday, January 09, 2006

Am J Med Qual - Dual-system use

are there implications for risk adjustment and quality assessment?
Rosen AK, Gardner J, Montez M, Loveland S, Hendricks A.
Am J Med Qual. 2005 Jul-Aug;20(4):182-94
Pubmed

Friday, January 06, 2006

Health Serv Res - CAHPS Hospital Survey Special issue

This special issue of Health Services Research focuses on Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospital Survey

December 2005 - Vol. 40 Issue 6p2 Page 1973-2181

Measuring Hospital Care from the Patients' Perspective: An Overview of the CAHPS® Hospital Survey Development Process
Goldstein, Elizabeth; Farquhar, Marybeth; Crofton, Christine; Darby, Charles; Garfinkel, Steven

Review of the Literature on Survey Instruments Used to Collect Data on Hospital Patients' Perceptions of Care
Castle, Nicholas G.; Brown, Julie; Hepner, Kimberly A.; Hays, Ron D.

What Do Consumers Want to Know about the Quality of Care in Hospitals?
Sofaer, Shoshanna; Crofton, Christine; Goldstein, Elizabeth; Hoy, Elizabeth; Crabb, Jenny

Role of Cognitive Testing in the Development of the CAHPS® Hospital Survey
Levine, Roger E.; Fowler, Floyd J.; Brown, Julie A.

Methods Used to Streamline the CAHPS® Hospital Survey
Keller, San; O'Malley, A. James; Hays, Ron D.; Matthew, Rebecca A.; Zaslavsky, Alan M.; Hepner, Kimberly A.; Cleary, Paul D.

Exploratory Factor Analyses of the CAHPS® Hospital Pilot Survey Responses across and within Medical, Surgical, and Obstetric Services
O'Malley, A. James; Zaslavsky, Alan M.; Hays, Ron D.; Hepner, Kimberly A.; Keller, San; Cleary, Paul D.

Patterns of Unit and Item Nonresponse in the CAHPS® Hospital Survey
Elliott, Marc N.; Edwards, Carol; Angeles, January; Hambarsoomians, Katrin; Hays, Ron D.

Equivalence of Mail and Telephone Responses to the CAHPS® Hospital Survey
Vries, Han; Elliott, Marc N.; Hepner, Kimberly A.; Keller, San D.; Hays, Ron D.

Assessment of the Equivalence of the Spanish and English Versions of the CAHPS® Hospital Survey on the Quality of Inpatient Care
Hurtado, Margarita P.; Angeles, January; Blahut, Steven A.; Hays, Ron D.

Case-Mix Adjustment of the CAHPS® Hospital Survey
O'Malley, A. James; Zaslavsky, Alan M.; Elliott, Marc N.; Zaborski, Lawrence; Cleary, Paul D.

Thursday, January 05, 2006

Am J Nurs - State of the Science on Safe Medication Administration

March 2005, Volume 105, Issue 3 supplement

Making Medication Administration Safe: Report challenges nurses to lead the way
Kathleen G. Burke, Diana J. Mason

Discussion & Recommendations: Safe Medication Administration: An invitational symposium recommends ways of addressing obstacles

Errors from the Consumer’s Perspective: Tragedy motivated one woman to take action
Ilene Corina

Executive Summary: The State of the Science on Safe Medication Administration symposium
Kathleen G. Burke

How We Think About Medication Errors: A model and a charge for nurses
Victoria L. Rich

Medication Errors: Why they happen, and how they can be prevented
Ronda G. Hughes, Eduardo Ortiz

Medication Reconciliation: Transfer of medication information across settings—keeping it free from error
Jane H. Barnsteiner

Technology and Safe Medication Administration
Mark Crawford, Janet Mullan, et al.

Toward Safer IV Medication Administration: The narrow safety margins of many IV medications make this route particularly dangerous
Patrice K. Nicholas, Christine R. Agius

Wednesday, January 04, 2006

J Clin Epidemiol - An Analysis of Administrative Data...

An Analysis of Administrative Data Found that Proximate Clinical Event Ratios Provided a Systematic Approach to Identifying Possible Iatrogenic Risk Factors or Complications.

Journal of Clinical Epidemiology 58:2005, 162-170.
W. Baine, S. Kazakova
Pubmed

Qual Saf Health Care - Supplements on Safety

Organisations and safety in healthcare
Quality and Safety in Health Care 2004 Dec; 13 (Suppl 2) : 1-56.

Patient safety methodology
Quality and Safety in Health Care 2003 Dec; 12 (Suppl 2) : 1-72.

Tuesday, January 03, 2006

Health Serv Res - Measurement special issue

This special issue of Health Services Research focuses on measurement issues in health services research and on the potential contributions of measurement toward quality improvement efforts.

October 2005 - Vol. 40 Issue 5p2 Page 1571-1711

Health Services Research: Critical Measurement Issues
Shirley Meehan, PhD, MBA

Measurement in Veterans Affairs Health Services Research: Veterans as a Special Population
Robert O. Morgan, PhD et al.

Validity of Measures Is No Simple Matter
Lee Sechrest, PhD

Integrating Validity Theory with Use of Measurement Instruments in Clinical Settings
P. Adam Kelly, PhD, MBA et al.

Measuring Diagnoses: ICD Code Accuracy
Kimberly J. O'Malley, PhD et al.

Measurement Issues in Health Disparities Research
Mildred Ramirez, PhD et al.

Conceptualizing and Categorizing Race and Ethnicity in Health Services Research
Marvella E. Ford, PhD et al.

Proxies and Other External Raters: Methodological Considerations
A. Lynn Snow, PhD et al.

Dynamic Assessment of Health Outcomes: Time to Let the CAT Out of the Bag?
Karon F. Cook, PhD et al.

Monday, January 02, 2006

AHRQ - Medical Teamwork and Patient Safety

The Evidence-based Relation

This paper present evidence to support the relation between team training and patient safety. It extends earlier work by Pizzi and colleagues who argue that Crew Resource Management (CRM) training has a great deal of potential as a safe patient practice.

Training medical professionals to operate as a well-coordinated team should enhance patient safety and lead to a reduction in medical errors.

http://www.ahrq.gov/qual/medteam/

PDF File