Measuring Quality Improvement in Healthcare

by Carey, Raymond G.; Lloyd, Robert C.

• ISBN13: 9780527762933
• ISBN10: 0527762938
• Format: Paperback
• Copyright: 1995-02-01
• Publisher: Asq Pr

Summary

This hook addresses the critical growing need among health care administrators and practitioners to measure the effectiveness of quality improvement efforts. The authors' straightforward discussions of data collection, variation, and process improvement incorporates "the voice of the customer" as a key element driving the improvement of processes and outcomes. The core of the book is a set of twelve case studies that show how to apply statistical thinking to health care processes.

Author Biography

Raymond G. Carey, Ph.D., is vice president of Quality Measurement at Lutheran General HealthSystem in Park Ridge, IL, and president of Parkside Associates, Inc., a national consulting healthcare survey and research firm.

Table of Contents

List of Figures	p. ix
List of Tables	p. xi
Foreword	p. xiii
Preface	p. xv
Acknowledgments	p. xix
Planning Your CQI Journey	p. 1
What Is Quality?	p. 4
Who Is Interested in Quality?	p. 6
A Quality Improvement Road Map	p. 8
Preparing to Collect Data	p. 13
Identifying an Opportunity for Improvement	p. 13
Prioritizing Opportunities	p. 16
Organizing a Team	p. 18
Clarifying the Process with Flowcharts	p. 19
Standardizing the Process	p. 23
Identifying Key Quality Characteristics	p. 24
Developing Operational Definitions	p. 25
Data Collection	p. 27
Data versus Information	p. 27
Components of a Data Collection Plan	p. 28
A Template for Data Collection	p. 38
Understanding Variation	p. 43
Depicting Variation	p. 44
Common versus Special Causes of Variation	p. 48
Consequences of Not Understanding Variation	p. 50
Using Run and Control Charts to Analyze Process Variation	p. 53
Constructing Run Charts	p. 54
Using Run Charts	p. 56
Using a Run Chart to Help Improve the Preadmission Testing Process	p. 61
Why Use Control Charts?	p. 61
The Elements of a Control Chart	p. 63
Basic Control Chart Theory	p. 63
Type I and Type II Errors	p. 67
Dividing a Control Chart into Zones	p. 68
Deciding Which Control Chart to Use	p. 70
Control Chart Case Studies	p. 79
Applying Statistical Thinking to Healthcare Processes	p. 79
Case Studies	p. 80
Analyzing the Net Operating Margin	p. 81
CBC Laboratory Turnaround Time	p. 88
Tracking the Success of Physical Therapy	p. 93
Days to Mail a Patient Invoice	p. 98
Admission Time into an Intensive Care Unit	p. 103
Emergency Room Bed Transfer Time	p. 111
Platelet Counts	p. 118
Primary Caesarian Sections	p. 122
Ranking Hospitals on Patient Satisfaction	p. 128
Patient Falls	p. 133
Use of Restraints with Psychiatric Patients	p. 139
Medication Errors	p. 145
Developing Improvement Strategies	p. 151
The Type of Variation Determines Your Strategy	p. 151
Right and Wrong Strategies	p. 152
Changing a Common-Cause System	p. 154
Tools to Identify KPVs	p. 158
Continued Monitoring	p. 164
How Much Improvement Is Enough?	p. 164
Using Patient Surveys for CQI	p. 165
A Self-Test on Survey Research	p. 166
Function of Patient Surveys in CQI	p. 167
Reliability and Validity	p. 170
Why Is Reliability Important?	p. 172
How Much Reliability Is Enough?	p. 173
Sampling	p. 173
Interviewer and Nonresponse Bias	p. 174
Report Format	p. 176
Benchmark Data	p. 177
Evaluating the Effectiveness of Interventions	p. 180
Summary	p. 181
Formulas for Calculating Control Limits	p. 183
The X-R Chart	p. 183
The XmR Chart	p. 184
The p-Chart	p. 185
The c-Chart	p. 185
The u-Chart	p. 186
References	p. 187
Index	p. 189
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