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PubMed1977

Evaluation of clinical chemistry laboratory performance in twenty Veterans Administration hospitals.

Twenty highly automated Veterans Administration (VA) Hospital laboratories participated in a study to evaluate their performances of routine chemistry tests. Ten of the laboratories had been identified as "superior" on the basis of previous College of American Pathologists Surveys. Several aspects of proficiency surveys were simultaneously examined: use of masked vs. unmasked survey specimens, methods of ranking, and comparison of medically useful performance criteria. The laboratories were found in general to be performing at the level of the state of the art and, more importantly, realistically meeting the criteria for medical needs for most routine tests. There was no difference between results obtained with masked and unmasked specimens. The ten "superior" laboratories showed slightly greater precision than the others, but were not more accurate, and two of them performed very poorly in the present study. The sum of squared SDI's was found to be a helpful technic for ranking and identifying outstanding and poor performances.

Blood Chemical Analysis↗
PubMed1990

The valuation of pastoral care by hospital administrators: a survey of selected for-profit and non-profit institutions.

This paper reports on a study of 600 hospital administrators, half of which were in non-profit institutions and half of which were in hospitals owned or managed by the Hospital Corporation of America. The project was designed to identify what differences, if any, existed between surveyed administrators in both types of institutions in their valuation of pastoral care. No significant differences were found between the two groups of administrators in the valuation of pastoral care. All administrators were found to be concerned about the quality of patient care and to value aspects of care such as pastoral care which are personal and difficult to quantify.

Analysis of Variance↗
PubMed1996

Total quality management in hospitals: the contributions of commitment, quality councils, teams, budgets, and training to perceived improvement at Veterans Health Administration hospitals.

Studies of total quality management as a means of improving health care quality to date have relied on case studies of individual teams or hospitals. The Total Quality Improvement Registry Project surveyed quality coordinators (n = 36) and quality improvement team leaders (n = 228) to collect both site-level and team-level data on quality improvement in Veterans Health Administration hospitals. Usable responses were received from 100% of quality coordinators and 73.7% (168) of team leaders. Site-level data include hospital structural characteristics and measures of training and commitment, as well as features and activities of the hospital quality councils. Team-level data include size, membership, task, age, activities, and a proxy measure of quality improvement. The authors report on the relations between levels of commitment to total quality management principles, training levels, activities of quality councils, and team formation and success. These data provide support for a model of commitment to quality improvement that involves four realms of influence within the medical centers: (1) management, (2) physician leadership, (3) physician staff and middle management, and (4) nurses and employees. The authors also report on the activities of quality councils and the relation of their activities to commitment and perceived improvement. Using bivariate correlation and multiple regression, the authors found that the age of the quality council, overall facility commitment to total quality management philosophy, and physician commitment are the most critical variables in explaining numbers of teams, training intensity, and total perceived improvement at this sample of medical centers. Specifically, we find that commitment to total quality management philosophy and the number of active teams explains 41% of the observed variation in quality improvement. In future articles, the authors will report details of team activities and the development of teams over time.

Budgets↗