Articles: outcome-assessment-health-care.
-
There are many dimensions to outcome measurement for patient care and this study focuses on one aspect of outcome, namely that which is most concerned with the immediate effects of nursing care. Traditionally, outcome studies have been almost exclusively concerned with measuring the clinical outcomes of care with very little attempt being made to assess the effect of the nurses' contributions to that care. One of this study's purposes has been to redress this imbalance. ⋯ These were tested, in a case study situation, on 15 wards at seven acute hospitals. Initial testing indicates that these outcome measures show promise as a valid and reliable evaluation instrument with the utility for easy application in the clinical setting. They are being presented as a possible way forward to assessing the outcomes of nursing care.
-
This article describes a process to risk-adjust multiple outcomes of care and aggregate them into integrative measures of quality. A methodology is outlined for anesthesia services which is designed to use the new data base that is being constructed by the American Association for Nurse Anesthetists. Most of the methods should apply to other health professions as well, if outcomes of care and risk factors can be identified. The basic approach is to choose either exemplary or adverse outcomes of care which are under the control of the provider and to standardize these outcomes to take into consideration multiple risk factors.
-
Healthc Manage Forum · Jan 1992
Hospital reimbursement in Alberta: outcomes management is on the way.
The Alberta government has initiated a process to alter fundamentally the way it pays hospitals. As with most provinces, Alberta has been paying hospitals for what they spend. The new Alberta model will initially pay hospitals for what they do and ultimately will pay hospitals for what they ought to do; that is, for the outcomes that should be achieved. ⋯ The HPI is the average predicted cost per case divided by the unweighted average actual cost per case. The HPI is intended as an interim measure only. Ultimately, the system will evolve into a true prospective case-based system with volume controlled via role statements and linked to clinical outcomes.
-
Comparative Study
Variation in trauma resuscitation and its effect on patient outcome.
There were significant differences in the time taken to resuscitate 257 trauma patients from four internationally recognized trauma centres. The fastest unit completed resuscitation in 15 min while the slowest took 105 min. This variation was not explained by differences in the type of patient dealt with, seniority of the team leader, or the number of personnel in the trauma team. ⋯ Although the slowest unit had the smallest trauma team (two people), larger numbers of personnel did not shorten resuscitation times. The time taken to carry out the ABC of the primary survey was significantly correlated with patient's physiological change in the resuscitation room (R = -0.63, P less than 0.0001 with systolic blood pressure; R = -0.68, P less than 0.01 with the revised trauma score). A multiple regression with survival as the dependent variable revealed that this time was also a predictor of the patient's eventual outcome (t = 3.18, P less than 0.005).