Optimizing Widely Reported Hospital Quality And Safety Grades

This practical, engaging book provides concise, real life-tested guidance to healthcare teams concerned with widely reported and incentivized hospital quality and safety metrics, offering both a conceptual approach and specific advice and frameworks for reviewing quality and safety numerator events, from the perspective and experience of clinicians and administrators working within the Ochsner Health System. The text opens with the rationale for closely managing widely (including publicly) reported hospital patient quality and safety measures. Attention is given to the financial implications of quality performance, with respect to both penalties and payment incentives used by payer organizations. It then reviews the major public ratings and their relevant methodologies, including CMS, AHRQ and NSHN. In addition, it addresses ratings by proprietary organizations that have a large member clientele, such as Vizient, USNews, Leapfrog, Healthgrades, CareChex and others. Each metric - for example, the AHRQ Patient Safety Indicators (PSIs), and other metrics such as readmission rate, risk adjusted complications, hospital-acquired conditions and mortality - is addressed in a stand-alone chapter. For each, the importance, approach to review, opportunity for optimization, and engagement of healthcare staff are reviewed and discussed. Overall, this book forefronts the benefits of a collaborative approach within a health system. The concurrent review process, multidisciplinary collaboration among quality improvement, clinical documentation, coding and medical staff personnel are all emphasized. Also described in detail is the approach to and specific opportunities for medical staff education and engagement. Additional key topics include Engagement of the Medical Staff and House Staff (i.e., residents and other trainees), Futile Care, Surgical Quality Improvement (NSQIP), Nursing Provider Partnership, and Translation of Data Review to Successful Performance Improvement. Specialty chapters on pediatric, neurologic and transplant quality metrics are also included.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Optimizing Endoscopic Operations, An Issue of Gastrointestinal Endoscopy Clinics

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Optimizing patient flow : advanced strategies for managing variability to enhance access, quality, and safety offers readers innovate techniques for maximizing patient flow and improving operations management while providing clear examples of successful impementation. This all-new book can help health care organizations to reduce and manage variability, thereby increasing the reliablity of systems and processes and improving health care quality and safety.

Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.