Journal for healthcare quality : official publication of the National Association for Healthcare Quality
-
Lucian L. Leape, MD, is a health policy analyst whose research has focused on error prevention and appropriateness of care. He is currently adjunct professor of health policy at the Harvard School of Public Health. ⋯ Recent awards include the Distinguished Service Award of the American Pediatric Surgical Association (1997), the Robert Wood Johnson Investigator Award (1998), the Donabedian Award from the Medical Care Section of the American Public Health Association (1999), the Cheers Award from the Institute for Safe Medication Practices (1999), and the Pinnacle Award from the American Pharmaceutical Association (2001). Dr. Leape is a graduate of Cornell University and Harvard Medical School and trained in surgery at Massachusetts General Hospital and at Boston Children's Hospital.
-
Large-scale change techniques and rapid redesign methodologies were used to improve the quality of care delivered to patients at the end of life in a large, multihospital healthcare delivery system. By bringing key stakeholders from across the system together at a symposium to formulate the vision and critical criteria for palliative care programs, as well as to develop a flexible set of design tools, each region in the system could respond to the unique needs of its own community. Hospice length of stay for the system improved by 100% in the year after the systemwide symposium.
-
Despite extensive research on defining and measuring quality of care, less attention has been given to consumers' views. The purpose of the study reported here was to identify indicators of quality of healthcare and nursing care important to clinic patients. The most important indicators of healthcare quality were getting better, getting care and services when needed, and having diagnoses and treatment options explained. The most important indicators of nursing care quality were communicating with the nurse, being treated with respect, being cared for by nurses who were up-to-date, teaching by the nurse, and not being rushed through the visit.
-
In an attempt to promote as pain free an experience as possible for patients and to improve how pain is managed in all settings, this 500-bed teaching hospital embarked on a hospital-wide quality improvement (QI) initiative. Initial measurement of clinicians' knowledge and attitudes related to pain and surveys on patient satisfaction identified improvement opportunities. ⋯ Major outcomes realized to date have been: (a) a significant increase (p = .01) in physicians and nurses discussing with their patients the importance of managing their pain, (b) development of processes for documenting pain as the fifth vital sign, and (c) a 26% decrease in the use of meperidine. The next steps will be comprehensive monitoring of the effectiveness of pain management by clinical service, increased patient and family education on pain, and development of a formalized pain management competency program for clinical staff.