Quality management in health care
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Qual Manag Health Care · Oct 2013
Effect of modest pay-for-performance financial incentive on time-to-discharge summary dictation among medical residents.
Evaluate the effect of a modest financial incentive on time-to-discharge summary dictation among medicine residents. ⋯ A modest financial incentive resulted in a marked improvement in the time-to-discharge summary dictation by medicine residents. Pay-for-performance programs may be an effective strategy for improving the quality and efficiency of patient care in academic medical centers.
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Qual Manag Health Care · Jan 2013
Effective communication network structures for hospital infection prevention: a study protocol.
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 implementation failure" in health care organizations. ⋯ To this effect, the study has potential to provide insights into communication structure and content associated with collective learning and culture change at the unit level. Results and insights are expected to lay a foundation for generating context-sensitive "evidence-based management" strategies for successful practice change at the unit level. An ultimate expected deliverable is the development of an "action-learning framework" for successful implementation of evidence-based practices in health care organizations.
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Qual Manag Health Care · Apr 2012
Comparative StudyRevisiting empowerment: a study of improvement work in health care teams.
This article reports on a study of team empowerment in a large clinic at a Swedish hospital. The focus of the study was to understand how a high degree of empowerment enabled the teams to develop and sustain a high level of performance. More specifically, a model of empowerment was used to identify important factors that contribute to team empowerment in 3 teams at the clinic. In the analysis of the empirical data, 21 factors were identified and the degree of empowerment in the 3 teams was assessed.
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Qual Manag Health Care · Apr 2012
Randomized Controlled Trial Comparative StudyHow team-based reflection affects quality improvement implementation: a qualitative study.
Quality improvement (QI) interventions in health care organizations have produced mixed results with significant questions remaining about how QI interventions are implemented. Team-based reflection may be an important element for understanding QI implementation. Extensive research has focused on individual benefits of reflection including links between reflection, learning, and change. ⋯ We used a template approach to code transcribed data and an immersion/crystallization technique to identify patterns and themes. Three types of team-based reflection and how each mattered for QI implementation were identified: organizational reflection promoted buy-in, motivation, and feelings of inspiration; process reflection enhanced team problem solving and change management; and relational reflection enhanced discussions of relational dynamics necessary to implement desired QI changes. If QI interventions seek to make changes where collaboration and coordination of care is required, then deliberately integrating team-based reflection into interventions can provide opportunities to facilitate change processes.
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Qual Manag Health Care · Apr 2012
Comparative StudyHospital care may not affect the risk of readmission.
: Thirty-day readmissions have become a focal point for reducing health care spending, because they are viewed as a marker of the quality of hospital care. However, if increased time in the hospital is associated with better care, attempts to shorten length of stay (LOS) may result in increased rates of readmission. As such, we sought to explore the association of an incremental added day in LOS with the rate of readmission. ⋯ : Our findings suggest that more hospital care may not affect the likelihood of readmission and thus denying payment for readmission may be unwarranted.