Continuous Quality Improvement in Health Care : Theory, Implementations, and Applications

by McLaughlin, Curtis P.; Kaluzny, Arnold D.

• ISBN13: 9780763727123
• ISBN10: 0763727121
• Edition: 3rd
• Format: Hardcover
• Copyright: 2005-08-12
• Publisher: Jones & Bartlett

Summary

Through a unique interdisciplinary perspective on quality management in heath care, this text covers the subjects of operations management, organizational behavior, and health services research. With a particular focus on Total Quality Management and Continuous Quality Improvement, the challenges of implementation and institutionalization are addressed using examples from a variety of health care organizations. Updated material includes a new focus on reducing medical errors, the introduction of CPOE, Baldridge Award criteria, and seven new case studies.

Table of Contents

Contributors	xiii
Preface	xvii
Foreword	xxiii
Acknowledgments	xxv
PART I---INTRODUCTION	1	(64)
Defining Quality Improvement	3	(38)
Curtis P. McLaughlin
Arnold D. Kaluzny
Institutional Improvement	4	(1)
Societal Learning	4	(1)
Professional Responsibility	5	(1)
Rationale and Distinguishing Characteristics	5	(4)
Elements of CQI	9	(3)
The Past and Future of Health Care Quality Management	12	(9)
Emergence of TQM	21	(7)
Application to Health Care Organizations	28	(2)
Comparing Industrial and Health Care Quality	30	(6)
Problems, Challenges, and Quality Issues in Health Care	36	(5)
Does TQM/CQI Work in Health Care?	41	(24)
Curtis P. McLaughlin
Kit N. Simpson
Early Lessons from the National Demonstration Project	42	(1)
Early Empirical Evidence	43	(11)
Advantages of CQI Application in Health Care	54	(5)
The Big Bang---The Quality Chasm	59	(1)
Convergence	60	(1)
Third Party Measurement Systems	60	(4)
Conclusion	64	(1)
PART II---BASICS	65	(124)
The Outcome Model of Quality	67	(28)
Susan I. DesHarnais
Curtis P. McLaughlin
A Conceptual Framework and Definitions of Quality	67	(4)
The History and Politics in the United States of Doing Quality Assessment Using Outcome Data	71	(10)
Risk Adjustment and Benchmarking of Outcome Data: Data Requirements and Risk-Adjustment Techniques for Comparing Health Outcomes Across Providers and/or Over Time	81	(5)
Uses of Risk-Adjusted Data: What is Benchmarking, and Why Might We Want to Do It?	86	(5)
Professional and Institutional Responses for Addressing Quality Issues in Health Care	91	(3)
Conclusions	94	(1)
Measurement and Statistical Analysis in CQI	95	(36)
Diane L. Kelly
Susan Paul Johnson
The Role of Variation in Quality Improvement	96	(6)
Measurement and Statistical Analysis	102	(7)
Quality Improvement Tools	109	(21)
Conclusion	130	(1)
Measuring Consumer Satisfaction	131	(23)
Shulamit L. Bernard
Lucy A. Savitz
Defining Consumer Satisfaction	132	(2)
Who Is the Consumer?	134	(1)
Why Measure Consumer Satisfaction?	135	(2)
Measuring Satisfaction	137	(10)
Conclusions	147	(7)
Appendix 5-A	148	(6)
Understanding and Improving Team Effectiveness in Quality Improvement	154	(35)
Bruce Fried
William R. Carpenter
Teams in Health Care	159	(2)
High Performance Teams and Quality Improvement	161	(2)
Understanding and Improving the Performance of Quality Improvement Teams	163	(9)
Resources and Support	172	(7)
Team Processes	179	(10)
PART III---IMPLEMENTATION	189	(90)
CQI, Transformation, and the ``Learning'' Organization	191	(20)
Vaughn M. Upshaw
Arnold D. Kaluzny
Curtis P. McLaughlin
Transforming Health Care	192	(2)
Accepting Continuous Improvement	194	(1)
Continuous Improvement and Managed Care	195	(1)
Getting to Mass Customization	196	(1)
The Task Ahead	197	(2)
Managing Transformation and Learning	199	(3)
Physician Leaders and Transformation	202	(8)
Conclusions	210	(1)
Measuring & Assessing Adverse Medical Events to Promote Patient Safety	211	(15)
Lucy A. Savitz
Shulamit L. Bernard
Defining Safety and Adverse Events	211	(3)
Evidence for Safe Practice	214	(2)
Adverse Medical Event Monitoring and Detection	216	(4)
Tools for Driving Evidence-Based Quality Improvement: The AHRQ PSIs	220	(5)
Conclusions	225	(1)
The Human Face of Medical Error: Classification and Reduction	226	(17)
Joseph G. Van Matre
Donna J. Slovensky
Curtis P. McLaughlin
Medical Errors	227	(2)
Why a Classification System?	229	(3)
Representing the Suggested Approach	232	(4)
Matching Countermeasures to Error Types	236	(4)
Adopting the Aviation Industry Approach	240	(1)
Multi-Causation and Cross-Sectional Focus	241	(1)
Conclusion	242	(1)
Information Management and Technology for CQI	243	(36)
Curtis P. McLaughlin
David C. Kibbe
Historical Underinvestment in Health Care Information Technology	243	(4)
Information for Organizational Improvements	247	(6)
Data Quality Concepts, Issues, and Technologies	253	(7)
Information Management Issues, Concepts, and Technologies	260	(7)
Information Technology for Interorganizational Quality Efforts and Policies	267	(10)
Future Directions and Trends for Information Technology in CQI	277	(2)
PART IV---APPLICATION	279	(166)
Integrating Approaches to Health Professional Development With Approaches to Improving Patient Care	281	(16)
Julie J. Mohr
Paul Batalden
Background	281	(2)
The Process of Professional Preparation and Development	283	(3)
Organizing, Delivering, and Improving Patient Care: Organization-Centered Strategies, Issue-Centered Strategies, and Microsystem-Centered Strategies	286	(10)
Conclusion	296	(1)
Quality Improvement in Primary Care: The Role of Organization, Collaboratives, and Managed Care	297	(21)
Leif I. Solberg
Thomas E. Kottke
Milo L. Brekke
Internal Factors: The Care Delivery Organization and QI	298	(5)
External Factors: The Care Delivery Organization and QI Managed Care and Purchasers	303	(2)
Quality Improvement Collaboratives	305	(2)
IMPROVE: A Test of a Managed Care-Sponsored QIC for Improving Primary Care Preventive Services Delivery	307	(8)
Conclusions and Recommendations	315	(3)
CQI in Contract Research Organizations	318	(39)
William A. Sollecito
Kaye H. Fendt
Growth of CROs	319	(5)
How CROs Work	324	(3)
CQI Customer Focus	327	(13)
Training and Empowerment	340	(4)
Leadership	344	(2)
Statistical Process Control-Statistical Thinking	346	(9)
Conclusions	355	(2)
Continuous Quality Improvement in Public Health Organizations	357	(50)
Glen P. Mays
Paul K. Halverson
Public Health and Quality Improvement	357	(2)
Critical Dimensions of Public Health Quality Improvement Initiatives	359	(12)
Implementation of Quality Improvement Initiatives in Public Health	371	(33)
Quality Improvement and Public Health: Key Implementation Issues	404	(3)
Inquiring into the Quality and Safety of Care in the Academic Clinical Microsystem	407	(17)
Julie J. Mohr
Paul Batalden
Paul Barach
Microsystem Theory	407	(4)
Improving Quality and Safety Within the Academic Clinical Microsystem	411	(12)
Conclusion	423	(1)
Quality: From Professional Responsibility to Public Policy and Back Again	424	(21)
Curtis P. McLaughlin
Arnold D. Kaluzny
Political Initiatives	424	(5)
Responding in a Market Economy	429	(1)
Health Care Disintermediation: An Expanding Force	430	(6)
The Future: Shifting Roles	436	(7)
Conclusion	443	(2)
PART V---ILLUSTRATION	445	(176)
Intermountain Health Care	447	(38)
Richard M.J. Bohmer
Amy C. Edmondson
Laura R. Feldman
Intermountain Health Care: Structure	448	(8)
Brent James, MD, M.Stat	456	(1)
History of Clinical Care Management at IHC	457	(7)
Change Infrastructure	464	(10)
Clinical Care Management: Operations	474	(6)
Realizing the Benefits of Clinical Management	480	(2)
The Long-term Plan	482	(1)
Case Analysis	483	(1)
Assignment Questions	483	(1)
Class Exercise	484	(1)
Quality in Pediatric Subspecialty Care	485	(12)
William A. Sollecito
Peter A. Margolis
Paul V. Miles
Robert Perelman
Richard B. Colletti
Background	486	(1)
Components	487	(2)
Organizational Structure	489	(4)
An Incremental Approach	493	(2)
Case Analysis	495	(1)
Assignment Questions	495	(1)
Class Exercise	496	(1)
Community-Based Quality Improvement Efforts in Kingsport, Tennessee	497	(25)
Curtis P. McLaughlin
Kit N. Simpson
Quality First	497	(2)
Community Competition	499	(1)
Community Cooperation	500	(7)
Other Events Take Over	507	(13)
Case Analysis	520	(1)
Assignment Questions	520	(1)
Class Exercise	521	(1)
West Florida Regional Medical Center	522	(25)
Curtis P. McLaughlin
The HCA CQI Process	523	(8)
Four Examples of Teams	531	(14)
Looking Ahead	545	(1)
Case Analysis	545	(1)
Assignment Questions	546	(1)
Class Exercise	546	(1)
Rex Healthcare and Service Line Teams	547	(13)
Curtis P. McLaughlin
Linda C. Jordan
Quality at Rex	548	(1)
Competition in the Research Triangle	549	(1)
History of Quality and Performance Improvement Efforts at Rex	550	(8)
Case Analysis	558	(1)
Assignment Questions	558	(1)
Class Exercise	559	(1)
Dr. Johnson, Network Medical Director	560	(19)
William Q. Judge
Curtis P. McLaughlin
Personal Background	561	(2)
Corporate Background	563	(10)
Dr. Johnson's Observations About the Job	573	(3)
Case Analysis	576	(1)
Assignment Questions	576	(2)
Class Exercise	578	(1)
North Carolina Science to Service Project	579	(24)
Beth Melcher
Christina Rausch
Historical Background	581	(2)
The North Carolina Situation	583	(1)
North Carolina's Response	584	(1)
Project Startup	585	(1)
Project Activities	586	(6)
General Issues and Observations	592	(1)
Staff Conclusions	593	(7)
Future Direction	600	(1)
Case Analysis	601	(1)
Assignment Questions	601	(1)
Class Exercise	602	(1)
Transforming Health Care: The President's Health Information Technology Plan	603	(18)
The Problem: Challenges to the U.S. Health Care System	604	(1)
The Solution---Health Information Technology	605	(3)
Implementation	608	(8)
Public-Private Partnership	616	(1)
Role of the National Coordinator for Health Information Technology	616	(1)
Reports From OPM, DOD, and VA	617	(2)
Conclusion	619	(1)
Case Analysis	619	(1)
Assignment Questions	619	(1)
Class Exercise	620	(1)
Appendix A---Malcolm Baldrige Award 2004 Health Care Criteria for Performance Excellence	621	(7)
Bibliography	628	(35)
Index	663