The Joint Commission journal on quality improvement
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Jt Comm J Qual Improv · Jun 1995
Quality with a human face? The Samuels Planetree model hospital unit.
Hospitals across the country are seeking to restructure the delivery of care. Planetree, an international consumer health care organization, works with hospitals to cultivate educated health care consumers and to create caring inpatient environments. This article gives an overview of Planetree's philosophy, examines staff and patient satisfaction, and contrasts Planetree with total quality management (TQM)/continuous quality improvement (CQI) as practiced at one hospital. PLANETREE'S PHILOSOPHY: Planetree's model differs from other patient-centered or patient-focused care models because of its emphasis on educating patients and making them active partners in the care process. To help make the hospital environment less forbidding, more homelike, and more conducive to social interaction, Planetree physically redesigns the hospital space. ⋯ Both Planetree and TQM/CQI have goals of improving the delivery of patient care, and there are times when these approaches work in concert. There are times, however, when the different vantage points of TQM/CQI and Planetree may raise different questions and foster different solutions. Questions are also raised regarding whether Planetree benefits all patients in the same way. Furthermore, since it is not clear if Planetree's vision of humanizing patient care brings the results it hopes for, a long-term multifaceted research program is called for.
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Jt Comm J Qual Improv · Feb 1995
Think globally, act locally: an approach to implementation of clinical practice guidelines.
In an environment of concern about the rising costs of medical care, the Vermont Program for Quality in Health Care (VPQHC; the program) was incorporated in 1988 as a nonprofit organization and in 1989 was made a peer review organization by the state legislature. The program acts a resource center for health care in Vermont, coordinating three functions: implementation and maintenance of a statewide database for healthcare quality; training for health care providers in continuous quality improvement (CQI) methods and support for their CQI projects; and focusing clinical study group work on specific diagnoses or procedures. ⋯ Think globally, act locally, might be the motto for the program. Implementing guidelines starts with obtaining national guidelines and literature but needs the use of local data to sharpen the focus on narrow areas to address. Specifically, it is unrealistic to tackle the entire problem at once. Success comes from finding specific opportunities for improvement.
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The Pediatric Cardiac Care Consortium (PCCC) is a collaborative, voluntary effort of pediatric cardiologists to gather and analyze data regarding operative results. ⋯ Use of the study group model, in which key members work with their institution to use and interpret the data, has been an effective strategy for data dissemination. The PCCC is exploring the concept of "model centers," which would probably be procedure specific. With additional funding, the database could be expanded to include morbidity measures, functional outcome, and long-term follow-up.
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Jt Comm J Qual Improv · Dec 1994
Using the PDSA cycle to standardize a quality assurance program in a quality improvement-driven environment.
At Parkview Episcopal Medical Center (Pueblo, Colorado), QA means not only quality assurance but also quality alarms-statistical monitoring and analysis of key indicators that lead to the discovery of opportunities for continuous improvement. Data are monitored using statistical process control. Continuous improvement supports quality assurance (QA) just as it supports all other functions at Parkview. ⋯ Successes with this form demonstrate that QA and quality improvement (QI) can be integrated, allowing processes and outcomes to be improved. Since standardization occurred successfully in 1993, QA has been integrated into the strategic-planning process for 1994. Expectations are that duplicate reports and data gathering will be eliminated.
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Jt Comm J Qual Improv · Aug 1994
Cleveland health quality choice: a model for collaborative community-based outcomes assessment.
Cleveland Health Quality Choice Coalition was established in 1989 as a voluntary, collaborative effort between hospitals, physicians, and purchasers in the Cleveland metropolitan area to assess the quality and efficiency of care in 31 hospitals. The objective of the project is to produce high-fidelity comparative hospital outcomes data that support market-based health care reform strategies. ⋯ The early success of Cleveland Health Quality Choice Coalition demonstrates that it is possible for purchasers and providers to cooperatively assess the quality of health care on a regional basis and to institute a market-based strategy for health care reform. Further evaluation is needed to determine how performance data being reported are used by purchasers in selecting health care and by hospitals for quality improvement.