Abstract:
:This article proposes a new class of control charts that may be used for monitoring and improving the quality of care. Unlike conventional control charts that rely on observed performance data, these charts use risk-adjusted data in addition to the observed data. The resulting time-ordered charts are capable of reducing time-to-time variation that may stem from uncontrollable changes in patient mix over time. Depending on how observed and risk-adjusted data are combined, proposed charts are categorized under the framework of either additive or multiplicative models. Risk-adjusted rates are obtained using multivariate logistic regression models. It was found that the risk-adjusted control charts could be effective in reducing biases that arise from variation in patient mix. These charts can potentially achieve higher sensitivity and specificity compared with ordinary control charts.
journal_name
Qual Manag Health Carejournal_title
Quality management in health careauthors
Hart MK,Lee KY,Hart RF,Robertson JWdoi
10.1097/00019514-200301000-00004keywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
5-19issue
1eissn
1063-8628issn
1550-5154journal_volume
12pub_type
杂志文章abstract::To improve processes in hospitals, a case study was conducted at a German university hospital, which consists of more than 30 clinics and institutes on a large campus. The case study focused on the analysis of the patient flow and of machine utilization in the radiology department. Radiological devices are spread over...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181bee127
更新日期:2009-10-01 00:00:00
abstract:INTRODUCTION:Real-time location systems (RTLS) and Lean management approaches have been employed to improve patient flow in clinical settings. This study explored the feasibility of using these methodologies in an outpatient resident ophthalmology clinic. METHODS:Patients, providers, and staff in Wilmer Eye Institute ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000075
更新日期:2015-10-01 00:00:00
abstract::Many hospitals are unable to successfully implement evidence-based practices. For example, implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs), is often challenging. This problem is broadly characterized as a "change implementation failure." A prospective...
journal_title:Quality management in health care
pub_type: 杂志文章,多中心研究
doi:10.1097/QMH.0000000000000017
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:Although 65% of the hospitals in Taiwan claim to be applying the clinical pathway concept, most hospitals do not implement this concept effectively. The purpose of this study was to determine the reasons for the improper or inappropriate application of the clinical pathway design in hospitals. METHODS:This ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200601000-00007
更新日期:2006-01-01 00:00:00
abstract::With costs and competitive pressures increasing, pharmaceutical sponsors and contract research organizations are examining the drug development process. Investigators who conduct clinical studies significantly impact research quality and, thereby, costs. This article reviews current investigator selection methods and ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199907030-00004
更新日期:1999-04-01 00:00:00
abstract::In determining intervention effects, quality improvement researchers typically use statistical testing--Fisher's "significance testing" and/or Neyman and Pearson's "hypothesis testing." Such tests are employed in an effort to demonstrate whether or not a statistically and practically significant difference exists when...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000338551.05512.1b
更新日期:2008-10-01 00:00:00
abstract::We present an approach to assessing the impact of surveillance for surgical site infections and providing feedback to surgeons on their progress, as part of continuous quality improvement. Adjusting for patient risk factors using the Standardized Mortality Ratio, there was a marked decrease over time in both SMR (1.3 ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199806030-00006
更新日期:1998-04-01 00:00:00
abstract::The p chart is widely used in health care and other service organizations as well as in manufacturing to monitor the proportion of observations with some particular characteristic for comparing several sources of data or for tracking a single source of data over time. The conventional approach is to use 3sigma limits ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000267449.32629.b1
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:The multifaceted nature of the transition of care from the triage unit to labor and delivery has historically led to confusion, delays, and errors in care. This study evaluated the effect of standardization of roles and communication on improving this transition. METHODS:A multidisciplinary team was assemble...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000191
更新日期:2018-10-01 00:00:00
abstract::Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implem...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31827dea7d
更新日期:2013-01-01 00:00:00
abstract::Improving health care quality is increasingly recognized as a national priority in the United States. As a result, more and more health care organizations can be expected to undertake quality improvement (QI) initiatives. A question being raised with increasing frequency is: "Which QI activities need review by an inst...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200307000-00006
更新日期:2003-07-01 00:00:00
abstract::The article describes the Breakthrough Series, a collaborative improvement model developed by the Institute for Healthcare Improvement. The model adapts and applies existing knowledge to multiple, similar sites to accomplish common aims. It has been used to address several of the most pressing issues in health care to...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199806040-00001
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:Implementing change in a health care organization poses structural and cultural challenges. DESIGN:We developed a survey derived from an existing organizational change model and distributed it to the target population of an impending change initiative. RESULTS:The respondents (59.2% response rate) indicated...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0000000000000061
更新日期:2015-07-01 00:00:00
abstract::Academic medical centers and clinicians have been slow to embrace continuous quality improvement. The Mount Sinai Medical Center in New York has created a new Department of Health Policy that combines an academic research mission with an administrative mission to demonstrate improving quality of care. This article dis...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604040-00006
更新日期:1996-07-01 00:00:00
abstract::Given the revolutionary changes occurring in the health care industry, there is increasing agreement that academicians and practitioners must collaborate to identify and prioritize major educational outcomes for health care management. Several competency initiatives have been undertaken or completed in health care and...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200211010-00006
更新日期:2002-10-01 00:00:00
abstract::"Quality" of care has become one of the main foci of the American health care system during the last 20 years. As costs escalated in all areas of health care, the purchasers and consumers of health care have begun to demand accountability for the products they purchase. The initial focus of the system was "quality of ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200407000-00005
更新日期:2004-07-01 00:00:00
abstract::The Agency for Health Care Policy and Research pain guidelines and implementation theories were used in this improvement initiative to ensure that evidence-based pain management reached every provider and patient in a large tertiary care hospital. Implementation strategies, products, and outcome measures are described...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199907020-00004
更新日期:1999-01-01 00:00:00
abstract::This article examines a recently implemented strategy to transfer responsibility for local public health service delivery from a county health department to a hospital-based integrated delivery system. Innovative quality management efforts at both local and state levels offer opportunities for sustained improvement in...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199705020-00003
更新日期:1997-01-01 00:00:00
abstract::Part II of this three-part tutorial focuses on the logistics of data collection. The author presents a checklist of things to consider when planning the details of a data collection effort; touches on the topics of bias and stratification; discusses examples of popular data collection methods; and points out some comm...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1994-07-01 00:00:00
abstract::This article briefly describes natural induction approach to knowledge discovery, and then applies it to the problem of bad habit relapse prevention by analyzing patients' diaries. Natural induction seeks patterns in data that are in forms easy to understand and interpret, because they resemble those in which humans r...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000308640.89602.b1
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The obesity epidemic threatens to shorten life expectancy and reduce the quality of life for large segments of the population. The purpose of this study was to develop a decision rule for referral to a weight-loss program on the basis of the relationship between body mass index (BMI) and self-rated overall h...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/01.QMH.0000281061.15108.f8
更新日期:2007-07-01 00:00:00
abstract::Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. ...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-199604030-00008
更新日期:1996-04-01 00:00:00
abstract::There are various methods to get some projections of health indicators that do not always produce satisfactory results. Our aim is to establish the rules for obtaining reliable projections, using simple models. In the procedure proposed here, there is no need, as in many other techniques, to directly connect the level...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract::Improvement will be constrained by the function-based organizational model found in most health care organizations. Most components of the typical organization are driven by the concept of division of labor. The organization needs to challenge the underlying assumptions and reengineer from top to bottom. Reengineering...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract:CONTEXT:The phrase "Science of Improvement" or "Improvement Science" is commonly used today by a range of people and professions to mean different things, creating confusion to those trying to learn about improvement. In this article, we briefly define the concepts of improvement and science, and review the history of ...
journal_title:Quality management in health care
pub_type: 历史文章,杂志文章
doi:10.1097/QMH.0b013e31829a6a15
更新日期:2013-07-01 00:00:00
abstract::The gastroenterology unit at the Höglands Hospital in Eksjö is responsible for the care of all 466 patients with inflammatory bowel disease (IBD) in a geographic area including approximately 115,000 inhabitants. In 2000, the frustration over an inadequate traditional outpatient clinic inspired us to redesign our outpa...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200701000-00006
更新日期:2007-01-01 00:00:00
abstract::The aim of this study was to explore and evaluate managers' views of a large-scale improvement program, including their experiences and opinions about improvement initiatives and drivers for change. The study is based on a survey used in 2 nationwide mappings of improvement initiatives and developmental trends in Swed...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e31828bc276
更新日期:2013-04-01 00:00:00
abstract::Quality is an illusive concept with different meanings to different people. Providers often define quality in terms of patient outcomes, professional standards of practice, predetermined criteria used to measure quality, and even subjective opinion. Patients describe quality in terms of the interpersonal aspects of ca...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/00019514-200008040-00002
更新日期:2000-07-01 00:00:00
abstract::A variety of approaches are available to monitor and quantify the frequency of medical errors and the harm associated with them. The University HealthSystem Consortium Patient Safety Net provides a categorical, rank-ordered approach for designating harm associated with medical errors but does not lend itself to routin...
journal_title:Quality management in health care
pub_type: 杂志文章
doi:10.1097/QMH.0b013e3181fa074e
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:Medical home care has been identified as a model for improving primary care delivery and population-specific quality and safety outcomes. Questions remain how this model affects older adult quality. This systematic review addresses 2 important questions: Are quality and safety outcomes associated with medical h...
journal_title:Quality management in health care
pub_type: 杂志文章,评审
doi:10.1097/QMH.0000000000000041
更新日期:2014-10-01 00:00:00