Pediatric clinics of North America
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Pediatr. Clin. North Am. · Aug 2009
ReviewMaking the case to improve quality and reduce costs in pediatric health care.
This article makes a case for the urgent need to improve health care quality and reduce costs. It provides an overview of the importance of the quality movement and the definition of quality, including the concept of clinical and operational quality. ⋯ The link between quality and cost is reviewed using the concept of value in health care, which combines quality and cost in the same equation. The article ends with a discussion of future directions of the quality movement, including emerging concepts, such as risk-adjustment, shared responsibility for quality, measuring quality at the individual provider level, and evolving legal implications of the quality movement, as well as the concept of a shared savings model.
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Pediatr. Clin. North Am. · Aug 2009
The medical home--improving quality of primary care for children.
The concept of a medical home appears to be a key driver for enhancing the value of health services as care systems are transitioned to meet the ongoing challenges of improving quality and containing costs. This article provides an overview of the challenges faced in United States health care delivery systems that affect child health, explains how the medical home might address them, describes methods for measuring quality in medical homes, and identifies barriers to implementation of the model.
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Pediatr. Clin. North Am. · Aug 2009
Model for improvement - Part 1: A framework for health care quality.
The Model for Improvement is a rigorous and reasonable method for busy health care practitioners to use to improve patient outcomes. The use of this model requires practice for clinicians to be comfortable, but mastery is critical to develop the necessary skills to participate in quality improvement initiatives. ⋯ The case study demonstrates how this methodology can be applied in any busy health care setting. Incorporating this approach to quality improvement into daily work will improve clinical outcomes and advance health care delivery and design.
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The primary focus of child health policy for the last twenty years has been on improving health care coverage and access. More recently, the focus has shifted to include not only coverage, but also the quality of the care received. ⋯ The growing emphasis on quality is reflected in provisions of the new Child Health Program Reauthorization Act of 2009 (CHIPRA) legislation. In addition to providing funding for health coverage for over four million more children, it also includes the most significant federal investment in pediatric quality to date.
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Pediatr. Clin. North Am. · Aug 2009
Model for improvement - Part Two: Measurement and feedback for quality improvement efforts.
Measurement and feedback are fundamental to quality improvement. There is a knowledge gap among health care professionals in knowing how to measure the impact of their quality improvement projects and how to use these data to improve care. This article presents a pragmatic approach to measurement and feedback for quality improvement efforts in local health care settings, such as hospitals or clinical practices. The authors include evidence-based strategies from health care and other industries, augmented with practical examples from the authors' collective years of experience designing measurement and feedback strategies.