Quality in Health Care

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ISBN: 9780834206250 | 0834206250
Cover: Hardcover
Copyright: 3/1/1995

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Here's a reference book that will explore the difficult issues facing quality management professionals and energize your approach to concerns you face daily. Examines quality in healthcare from both a historical, and current perspective. You'll get proven strategies on how to survive in today's managed care environment. Explore the extensive framework of quality in healthcare and discover how it relates to other industries. Examine real life situations, explore the benefits, and the pitfalls to avoid. Plus, visualize the quality process with the help of charts and tables, and easy-to-understand diagrams.

Foreword

xiii

Richard J. Coffey

Preface

Acknowledgments

xvii

PART I---YESTERDAY

(72)

Nancy O. Graham

Questions for Thought, Discussion, and Research

(1)

Quality Trends in Health Care

(12)

Nancy O. Graham

Three Models for Delivering Health Care

(2)

Historical Perspective

(7)

Conclusion

(3)

A Double Take on the History of Quality in Health Care

(17)

John F. Racine

Introduction

(1)

Yesterday

(3)

Today

(2)

Tomorrow

(3)

Conclusion

(8)

Selected Health Care Quality Milestones

(3)

Selected Health Care Quality Pioneers

(2)

The Quality of Care: How Can It Be Assessed?

(15)

Avedis Donabedian

Specifying What Quality Is

(9)

Sampling

(1)

Measurement

(1)

Information

(1)

Conclusion

(3)

Variations in Medical Practice and Hospital Costs

(17)

John E. Wennberg

The Practice Variation Phenomenon

(9)

A Plan for Action

(8)

Continuous Improvement As an Ideal in Health Care

(9)

Donald M. Berwick

The Theory of Bad Apples

(1)

The Theory of Continuous Improvement

(5)

Conclusion

(2)

PART II---TODAY

(224)

Nancy O. Graham

Questions for Thought, Discussion, and Research

(2)

Total Quality Management

(13)

George W. Whetsell

What Is Total Quality Management?

(11)

Conclusion

(1)

Tutorial: Quality Improvement Project Models

(22)

Paul E. Plsek

Basic Concepts Underlying Quality Improvement Project Models

(7)

Analysis of Some Common Quality Improvement Project Models

100

(7)

The Need for and Value of Quality Improvement Project Models

107

(1)

On Becoming Multilingual in Understanding Quality Improvement Projects

108

(1)

Selecting a Quality Improvement Project Model

109

(5)

The Quality Improvement Process

113

(1)

Bringing Theory into Practice---Applying Improvement Thinking

114

(25)

C.J. Bolster

Elizabeth Falter

Laura Hooper

Part I

114

(1)

Introduction

114

(1)

Overall Approach

115

(1)

Detailed Approach---The Key Elements

116

(3)

Team Building---An Essential Ingredient

119

(1)

Part II

120

(1)

Introduction

120

(1)

Leadership Structure

120

(3)

External Benchmark

123

(1)

Internal Baseline

124

(3)

Design Best Practices

127

(6)

Guidelines for Stroke Protocol Development

133

(3)

Implement

136

(1)

Measure and Monitor

137

(1)

Improve

137

(1)

Conclusion

138

(1)

An Introduction to Critical Paths

139

(18)

Richard J. Coffey

Janet S. Richards

Carl S. Remmert

Sarah S. LeRoy

Rhonda R. Schoville

Phyllis J. Baldwin

Concepts, Definitions, and Roles

140

(3)

Dimensions of Critical Paths

143

(2)

Uses of Critical Paths

145

(5)

Establishing and Using Critical Paths

150

(3)

Results

153

(2)

Conclusion

155

(2)

Implementing Practice Guidelines through Clinical Quality Improvement

157

(31)

Brent C. James

Process Management

158

(2)

Implementing Practice Guidelines: Background Principles

160

(2)

Implementing Practice Guidelines: Definitions

162

(3)

Implementing Practice Guidelines: A Case Study

165

(4)

Implementing Practice Guidelines: Lessons Learned

169

(12)

Conclusion

181

(7)

The Outcomes Movement: Will It Get Us Where We Want To Go?

188

(10)

Arnold A. Epstein

The Origins of the Outcomes Movement

189

(1)

New Directions in Assessing Outcomes

190

(1)

The Goals and Limitations of the Outcomes Movement

191

(3)

Implications for the Future

194

(4)

The Role of Outcomes in Quality Assessment and Assurance

198

(12)

Avedis Donabedian

The Structure-Process-Outcome Paradigm

201

(3)

The Use of Outcomes in Quality Assessment

204

(6)

Benchmarking

210

(13)

Craig Anderson

Peggy A. Rivenburgh

Types of Benchmarking

210

(3)

The Benchmarking Process

213

(2)

Application of the Benchmarking Process

215

(1)

The Malcolm Baldrige National Quality Award

215

(1)

The Status of Benchmarking in Health Care

216

(2)

Benchmarking in the Future

218

(5)

Quality Assurance and Quality Improvement in the Information Age

223

(8)

Kathryn L. Coltin

David B. Aronow

Introduction

223

(1)

Automated Information Systems and Quality Assurance/Quality Improvement

224

(1)

Information Needs for QI/QA: Similarities and Differences

225

(2)

Usefulness of Automated Information Systems

227

(1)

Pragmatic and Policy Issues

228

(3)

Integrating Strategic Planning and Quality Management in a Multi-Institutional System

231

(18)

Steve Durbin

Claudia Haglund

William Dowling

The Sisters of Providence Philosophy Regarding Quality

232

(1)

Situational Assessment of TQM Implementation

233

(2)

The Role of Quality in the Strategic Planning Process

235

(6)

Development of Quality Goals and Strategies

241

(2)

Implementation of Quality Strategies

243

(1)

Measurement of Quality Performance

244

(5)

Building Learning Organizations

249

(16)

Peter Senge

The Roots of the Quality Movement

251

(4)

Improving How We Work

255

(4)

A Short Study on Learning As a Way of Organizational Life

259

(3)

Why Becoming a Learning Organization Matters

262

(2)

Final Thoughts

264

(1)

Quality Improvement: A Patient's Perspective

265

(8)

Charles E. Silberman

Introduction

265

(1)

Perceptions of Illness and Disease

266

(2)

Improving the Quality of Health Care

268

(3)

Conclusion

271

(2)

Changing Physicians' Practices

273

(9)

Peter J. Greco

John M. Eisenberg

Education

274

(1)

Feedback

275

(1)

Participation by Physicians in the Effort To Change

275

(1)

Administrative Interventions

276

(1)

Financial Incentives and Penalties

277

(1)

Future Directions

277

(5)

Overcoming the Barriers to Implementation of TQM/CQI in Hospitals: Myths and Realities

282

(15)

Douglas S. Wakefield

Bonnie J. Wakefield

Challenges to Implementation and Integration of TQM and CQI in Hospitals

283

(1)

Physicians: The Nonemployee Critical Players

284

(2)

Interprofessional Boundary Conflict and Control

286

(2)

Use of Vertical Hierarchies To Manage Interprofessional Relationships

288

(1)

Emphasis on Individual Rather Than Group Performance

289

(2)

Clinical Knowledge and Skills Are Not Substitutes for Management Knowledge and Skills

291

(2)

Resistance to Using Statistical Quality Control Methods

293

(4)

PART III---TOMORROW

297

(38)

Nancy O. Graham

Health Care in the Future

297

(1)

The Future of Health Care Organizations

298

(2)

Questions for Thought, Discussion, and Research

300

(3)

The Reshaping of Health Care

303

(12)

Jeff C. Goldsmith

Unraveling the Genetic Roots of Illness

304

(2)

Human Genome Project

306

(1)

The End of Insurance?

306

(1)

Do-It-Yourself Eugenics

307

(1)

Opportunities To Reduce Illness

308

(1)

The ``Liquid Nervous System''

309

(2)

Man-Made Antibodies

311

(1)

Conquering Autoimmune Diseases

312

(1)

Begged Questions

313

(2)

Five Futures

315

(20)

Clement Bezold

Unique Images

316

(1)

Continued Growth/High Tech

316

(2)

Hard Times/Government Leadership

318

(2)

Buyers' Market

320

(3)

A New Civilization

323

(3)

Healing and Health Care

326

(9)

The New Values and Competencies

330

(5)

Afterword

335

(1)

Appendix A---Case Study: TQM in a Community Hospital

336

(5)

Rita DiPippo

Steven Schoener

Appendix B---The Health Care Quality Improvement Initiative: A New Approach to Quality Assurance in Medicare

341

(12)

Stephen F. Jencks

Gail R. Wilensky

Appendix C---Clinical Performance Standards

353

(2)

The Joint Commission on Accreditation of Healthcare Organizations

Appendix D---Glossary of Terms

355

(4)

Index

359

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Quality in Health Care

Summary

Table of Contents

Supplemental Materials

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