Quality management in health care
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Qual Manag Health Care · Jan 2002
Comparative StudyStructural versus outcomes measures in hospitals: a comparison of Joint Commission and Medicare outcomes scores in hospitals.
Outcomes performance measures are increasingly important in health care. The Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) continues to rely on structure and process measures based on accepted good practice. One of the first tasks in moving to a more outcomes-oriented approach is to compare the two measurement approaches. ⋯ Joint Commission measures are generally not correlated with outcome measures. The few significant correlations that appear are often counterintuitive. We conclude that a potentially serious disjuncture exists between the outcomes measures and Joint Commission evaluations.
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Qual Manag Health Care · Jan 2002
Building and assessing competence: the potential for evidence-based graduate medical education.
The Accreditation Council for Graduate Medical Education (ACGME) has recently begun to use educational outcome measures as an accreditation tool. This long-term initiative offers the potential for building knowledge about effective educational interventions and ultimately for using time-variable educational models. ⋯ Skill sets and accountability proceed along a continuum that is outlined. Crucial is the development of a community committed to discerning and obeying the truth about the effectiveness of educational interventions.
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Qual Manag Health Care · Jan 2002
Enhancing VHA's mission to improve veteran health: synopsis of VHA's Malcolm Baldrige award application.
The Veterans Health Administration (VHA) provides health care value to an aging veteran population in the midst of rising health care costs and the necessity to demonstrate improvements in the quality of care. The Malcolm Baldrige framework offers a comprehensive assessment of the organization's management system, performance improvements, and the promise to enhance health outcomes, including quality and patient satisfaction. This article will describe the development, current status, and future plans within VHA for the Malcolm Baldrige Award for Healthcare.
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Qual Manag Health Care · Jan 2002
A model of medical error based on a model of disease: interactions between adverse events, failures, and their errors.
This article discusses Rush-Presbyterian-St. Luke's Medical Center's approach to assessing and preventing errors in care and promoting patient safety. The word error is applied to all kinds of events, including adverse occurrences, negligence, and malpractice. ⋯ A patient safety committee standardized the definition of medical error and developed a taxonomy for error as a prelude to efforts at error reduction. It identified three levels or layers that can represent a train of events culminating in an undesired outcome: error, treatment failure, and adverse event. This discussion is offered in the interest of clarifying some of the issues.