Biomedical subjects

William M Barron

Publications and source records attributed to William M Barron.

2 recordsLinked to original sources

PubMed2005

Critical success factors for performance improvement programs.

BACKGROUND: Most health care organizations struggle with the design and implementation of effective, systemwide improvement programs. In 2000, the University HealthSystem Consortium initiated a benchmarking project to identify the organizational elements that predict a successful perfermance improvement (PI) program and that are best suited to support change initiatives. METHODS: Forty-one organizations completed a survey about the presence of critical components, processes used to improve performance, and organizational PI structures. Follow-up site visits were conducted at three organizations. CRITICAL SUCCESS FACTORS FOR A PI PROGRAM: Eight organizational success factors for an effective performance improvement program were identified: (1) Strong Administrative Fxecutive and Performance Improvement Leadership, (2) Active Involvement of the Board of Trustees, (3) Effective Oversight Structure, (4) Expert Performance Improvement Staff, (5) Physician Involvement and Accountability, (6) Active Staff Involvement, (7) Effective Use of Information Resources-Data Used for Decision Making, and (8) Effective Communication Strategy. DISCUSSION: The approach offered is grounded in the belief that effective organizational structures and processes are prerequisites to improving health care delivery. Although some empirical support for the proposed model is provided, additional research will be required to determine the effectiveness of this approach.

Benchmarking↗

PubMed2003

Unanticipated harm to patients: deciding when to disclose outcomes.

BACKGROUND: Patient safety standards of the Joint Commission on Accreditation of Healthcare Organizations require that "patients and, when appropriate, their families are informed about the outcomes of care, including unanticipated outcomes." WHAT OUTCOMES SHOULD TRIGGER DISCLOSURE: Given that all medical treatments have an array of possible outcomes, how do we confidently say that an outcome is unanticipated? It is proposed that an adverse outcome meet one of two criteria to be considered unanticipated: (1) It would not be included in a reasonable informed consent process for treatment of the patient's condition(s) and/or would not be expected during the usual course of treatment; and (2) it may have been caused by human or systemic error--that is, it is not immediately possible to clearly and decisively rule out error. This definition requires less judgment because it represents an extension of the existing norms of communication that are expressed through the process of informed consent. The norms of the informed consent process require that the patient be given all pertinent information needed to participate in future treatment decision making. CONCLUSIONS AND RECOMMENDATIONS FOR ORGANIZATIONAL POLICIES: Institutional policies and procedures should provide a clear approach to the identification, reporting, and discussion of unanticipated adverse outcomes, whether or not they are associated with error, as well as guidance and an educational program to help physicians, staff, and students disclose unanticipated adverse events and error in the most appropriate manner.

Humans↗