The Joint Commission journal on quality improvement
-
Jt Comm J Qual Improv · Feb 1999
AMA Clinical Quality Improvement Forum ties it all together: from guidelines to measurement to analysis and back to guidelines.
In Chicago October 15, 1998, the American Medical Association (AMA) Department of Clinical Quality Improvement introduced a broadened scope for its Practice Parameters Forum, now retitled the Clinical Quality Improvement Forum. The Forum will now focus on integrating all the components of what the AMA has identified as the quality continuum-clinical practice guidelines, performance measurement, and process and outcomes analysis. ⋯ CLINICAL OUTCOMES MEASUREMENT: If outcomes can be associated with specific processes of care, clinical practice guidelines can be refined. However, outcomes are dependent on factors outside physicians' behavior and control, such as patient compliance, comorbidities, and other risk factors, and consequently consideration of these variables is essential to appropriately interpreting the data.
-
Jt Comm J Qual Improv · Feb 1999
Integrating clinical performance improvement across physician organizations: the PhyCor experience.
There is a paucity of literature describing the implementation of clinical performance improvement (CPI) efforts across geographically dispersed multispecialty group practices and independent practice associations. PhyCor, a physician management company based in Nashville, Tennessee, has integrated CPI initiatives into its operating infrastructure. PhyCor CPI INITIATIVES: The strategic framework guiding PhyCor's CPI initiatives is built around a physician-driven, patient-centered model. Physician/administrator leadership teams develop and implement a clinical and financial strategic plan for performance improvement; adopt local clinical and operational performance indicators; and agree on and gain consensus with local physician champions to engage in CPI initiatives. The area/regional leadership councils integrate and coordinate regional medical management and CPI initiatives among local groups and independent practice associations. In addition to these councils and a national leadership council, condition-specific care management councils have also been established. These councils develop condition-specific protocols and outcome measures and lead the implementation of CPI initiatives at their own clinics. ⋯ Physician leadership and strategic vision, CPI-oriented organizational infrastructure, broad-based physician involvement in CPI, providing access to performance data, parallel incentives, and creating a sense of urgency for accelerated change are all critical success factors to the implementation of CPI strategies at the local, regional, and national levels.