Joint Commission journal on quality and patient safety / Joint Commission Resources
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Jt Comm J Qual Patient Saf · Apr 2011
A two-pronged quality improvement training program for leaders and frontline staff.
A unique two-pronged QI training program was developed at Emory Healthcare (Atlanta), which encompasses five hospitals and a multispecialty physician practice. One two-day program, Leadership for Healthcare Improvement, is offered to leadership, and a four-month program, Practical Methods for Healthcare Improvement, is offered to frontline staff and middle managers. KNOWLEDGE ASSESSMENT: Participants in the leadership program completed self-assessments of QI competencies and pre- and postcourse QI knowledge tests. Semistructured interviews with selected participants in the practical methods program were performed to assess QI project sustainability and short-term outcomes. ⋯ This initiative shows the feasibility of implementing a broad-based in-house QI training program for multidisciplinary staff across an integrated health system. Initial assessment shows knowledge improvements and successful QI project implementations, with many projects active up to one year following the courses.
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Jt Comm J Qual Patient Saf · Apr 2011
Does the Veterans Affairs depression performance measure predict quality care?
In 2000, the Department of Veterans Affairs (VA) instituted a performance measure to improve the quality of depression care. The measure evaluated adequacy of follow-up for depressed patients but was removed from clinic directors' performance plans in fiscal year (FY) 2009 because it had not been empirically validated. The VA depression performance measure was compared with an empirically validated model for assessing adherence to important depression treatment processes. ⋯ The highest-performing sites on the VA depression performance measure adhered to important care processes more often than did the lowest-performing sites.
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Jt Comm J Qual Patient Saf · Apr 2011
High rates of venous thromboembolism prophylaxis did not increase the incidence of heparin-induced thrombocytopenia.
Venous thromboembolism (VTE) prophlaxis is recommended for most hospitalized patients. At a 505-bed urban academic medical center, the rate of VTE prophylaxis recently increased from 50%-55% to > 95% of eligible patients. Heparin-induced thrombocytopenia (HIT) is a potentially devastating, but rare, reaction to medications commonly used for VTE prophylaxis. ⋯ Optimizing the VTE prophylaxis rate to > 95% of eligible patients at a single academic institution did not cause an increase in the rate of HIT. Concerns about HIT should not limit implementation ofVTE prophylaxis protocols. HIT surveillance in patients on VTE prophylaxis may have a very low yield.
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Jt Comm J Qual Patient Saf · Apr 2011
Paying for outcomes, not performance: lessons from the Medicare Inpatient Prospective Payment System.
Drawing on lessons learned from the implementation of the Medicare Inpatient Prospective Payment System (IPPS), the authors propose principles for the design and implementation of a hospital payment system based on paying for outcomes.