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Results for “Performance benchmarking”

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At least 631 records · Page 35Linked to original sources
PubMed1999

Evaluating clinical decision-making skills of nurse practitioner students.

The evaluation of clinical competencies of nurse practitioner (NP) students has traditionally been accomplished by direct observation of student-patient interactions. Adult and family NP faculty at the Medical University of South Carolina directly observe students at their clinical site at least twice each semester. Recently, faculty recognized the need for additional validation of clinical decision-making skill development and added the Clinical Competency Evaluation (CCE), a standardized simulated patient encounter, to the evaluation process. The purpose of the CCE is to (a) maximize use of available evaluation technology, (b) evaluate student clinical skills in a controlled, standardized environment using a criterion-referenced format, (c) give students an additional performance feedback mechanism, and (d) identify benchmarks to validate student advancement and completion of the NP program. This article discusses how the CCE process was developed, current methods of conducting and grading the examination, faculty and student evaluation of the outcomes, and recommendations.

Adult↗
PubMedDate not supplied

The power of the soul. Business expertise is not enough; executives in Catholic health care must be spiritual leaders, too.

After more than 20 years in health care, including at least a decade in leadership, this day was perhaps my darkest on the job. Since becoming chief operating officer of this Catholic hospital, I, with the help of my management team, had struggled to find answers to apparently overwhelming financial and operational challenges. I had been forced to make tough decisions in the pursuit of financial stability. In round-the-clock meetings, my team and I (with the assistance of a consulting firm whose specialty was turnarounds) had dissected every aspect of the operation. I had compared the performance of the hospital to industry benchmarks, never wanting to be unfair in expecting more from my staff than others had accomplished. In fact, in every decision I made I tried to be fair, weighing the different interests at stake before choosing a course of action--all the while knowing that, no matter what, I would make someone angry. Those around me, instead of recognizing my efforts to be fair, seemed to feel they had been betrayed. The whole organization was dispirited. My medical staff support was eroding as physicians refocused their practices at other facilities not faced with the challenges I had to address. Local leaders roundly criticized me for what they saw as abandoning the community's needs in the interest of serving the hospital and its bottom line. Then came the most hurtful news of all. My employees had filed a petition for representation by a union. It was not that I had a problem with organized labor. But how could an organization that I led have come to a place where the staff felt so abandoned by my leadership that they needed someone else to represent and protect their interest? Hadn't I tried hard to educate the staff about the changes in health care reimbursement? Hadn't I told them that the very existence of the hospital was at stake? Didn't they see how hard I worked, how much I cared? What was I to do now?

Catholicism↗
PubMedDate not supplied

Developing and implementing a relational database for heart failure outcomes in an integrated healthcare system.

A need to capture patient-specific data related to heart failure outcomes led to the development of a relational database to allow for data entry at the point of care. This database provided standardization of data collection at four of the system's acute care hospitals. The data are reported to the Heart Failure Clinical Effectiveness Team to track indicators for demonstration of best practice outcomes, internal benchmarking, and identification of opportunities for performance improvement on a healthcare system level. The database development, steps toward implementation, data collection tools, and the utilization of the outcomes data are discussed.

Databases, Factual↗
PubMed2004

What insurers know about your hospital ... and how they are using it.

Insurers are using their purchasing power and their enormous stores of claims data to push hospitals to improve quality. Health plans are able to parse the data according to such quality indicators as cost, length of stay and outcomes. Hospitals are wary of the trend, but some welcome it, especially if insurers use the so-called pay-for-performance model.

Benchmarking↗
PubMed2002

Neuropsychological performance and integrated evaluation for disabled people using Virtual Reality: integrated VR profile.

This chapter describes a Virtual Reality (VR) based innovative model of evaluation of the performance and potentiality of young mentally/psychically disabled subjects with learning difficulties. Using an immersive PC-based VR system, the study investigated the characteristics of 150 disabled subjects in the EU funded project "Horizon O.D.A.--Catania-1998--2000". The result is the definition of an individual neuropsychological "Integrated Profile", based on VR performance, that allows an objective functional benchmark between different subjects. This model can be used to investigate the possibility of job integration for mentally/psychically disabled subjects.

Adolescent↗
PubMedDate not supplied

Rural versus urban home health: does locale influence OASIS outcomes?

As home health administrators select performance evaluation systems to meet the benchmark requirements of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a frequently asked question is: Does rural versus urban locale influence patient outcomes? To answer the question, patient outcome data were collected from rural and urban home health agencies. Data analysis showed better outcomes for rural than for urban patients. Locale predicted less than 1% percent of the variance in each of the five outcomes studied. Factors that could account for rural-urban outcome differences were suggested.

Aged↗
PubMed2003

Health plan quality-of-care information is undermined by voluntary reporting.

BACKGROUND: Most health services in the United States are delivered by managed care organizations (MCOs). Publicly available, plan-specific performance information is required to adequately assess healthcare quality provided. Using women's health indicators, we compared performance results for MCOs and evaluated whether those MCOs that publicly report quality-of-care (QOC) results demonstrate better QOC than those plans that restrict public access to data. METHODS: Data from the Health Plan Employer Data and Information Set (HEDIS) for commercial MCOs in 1998 were analyzed for women's QOC indicators. Plan-specific, regional, and national performances were analyzed and results compared to established benchmarks. Public-reporting plans were compared to plans that restrict access to QOC information. Linear regression was used to identify determinants of health plan performance including public release of information. RESULTS: Commercial MCOs had wide variations in QOC indicators and, on average, failed to attain national health goals for most women's health indicators analyzed. Plans that restricted public access to QOC information had poorer performance than those that did not (p<0.05). Results suggest that whether a plan publicly releases its performance information is highly associated with health plan performance even after taking into account other factors. CONCLUSIONS: The voluntary aspect of reporting and the ability of health plans to restrict public access is allowing poorer performing health plans to escape public scrutiny. Variations in QOC have clinical significance and, if publicly available, would enable individuals to select high-quality healthcare products. The ability of health plans to restrict public information is not consistent with the 1973 Health Maintenance Organization Act requiring public information on health plan quality. A national strategy to ensure that QOC information is available on all healthcare systems is past due.

Adult↗
PubMed2005

Quantitative measures of performance in microvascular anastomoses.

OBJECTIVE: Methods of evaluating surgical performance are mainly subjective. This study introduces a method of evaluating surgical performance using a quantitative analysis of tool tip kinematics. METHODS: One experienced surgeon performed eight rat microvascular anastomoses over a 2-day interval. An optoelectronic motion analysis system acquired tool tip trajectories at frequencies of 30 Hz. On the basis of a hierarchical decomposition, the procedure was segmented into specific surgical subtasks (free space movement, needle placement and knot throws) from which characteristic measures of performance (tool tip trajectory, excursion and velocity) were evaluated. Comparisons of performance measures across each procedure were indexed (D scale) using the Kolmogorov-Smirnov statistic. RESULTS: Despite the marker occlusions, tool tip data were obtained 92 +/- 7% (mean +/- SD) of the time during manipulation tasks. Missing data segments were interpolated across gaps of less than 10 sample points with errors less than 0.4 mm. The anastomoses were completed in 27 +/- 4 min (range 20.5-31.4 min) with 100% patency. Tool tip trajectories and excursions were comparable for each hand, while right and left hand differences were found for velocity. Performance measures comparisons across each procedure established the benchmark for an experienced surgeon. The D-scale range was between 0 and 0.5. CONCLUSION: The study establishes a reproducible method of quantitating surgical performance. This may enhance assessment of surgical trainees at various levels of training.

Anastomosis, Surgical↗
PubMed2005

Critical evaluation of the JDO API for the persistence and portability requirements of complex biological databases.

BACKGROUND: Complex biological database systems have become key computational tools used daily by scientists and researchers. Many of these systems must be capable of executing on multiple different hardware and software configurations and are also often made available to users via the Internet. We have used the Java Data Object (JDO) persistence technology to develop the database layer of such a system known as the SigPath information management system. SigPath is an example of a complex biological database that needs to store various types of information connected by many relationships. RESULTS: Using this system as an example, we perform a critical evaluation of current JDO technology; discuss the suitability of the JDO standard to achieve portability, scalability and performance. We show that JDO supports portability of the SigPath system from a relational database backend to an object database backend and achieves acceptable scalability. To answer the performance question, we have created the SigPath JDO application benchmark that we distribute under the Gnu General Public License. This benchmark can be used as an example of using JDO technology to create a complex biological database and makes it possible for vendors and users of the technology to evaluate the performance of other JDO implementations for similar applications. CONCLUSIONS: The SigPath JDO benchmark and our discussion of JDO technology in the context of biological databases will be useful to bioinformaticians who design new complex biological databases and aim to create systems that can be ported easily to a variety of database backends.

Computational Biology↗
PubMed2006

Benchmark study of DFT functionals for late-transition-metal reactions.

The performance of a wide variety of DFT exchange-correlation functionals for a number of late-transition-metal reaction profiles has been considered. Benchmark ab-initio reference data for the prototype reactions Pd + H2, Pd + CH4, Pd + C2H6 (both C-C and C-H activation), and Pd + CH3Cl are presented, while ab-initio data of lesser quality were obtained for the catalytic hydrogenation of acetone and for the low-oxidation-state and high-oxidation-state mechanisms of the Heck reaction. "Kinetics" functionals such as mPW1K, PWB6K, BB1K, and BMK clearly perform more poorly for late-transition-metal reactions than for main-group reactions, as well as compared to general-purpose functionals. There is no single "best functional" for late-transition-metal reactions, but rather a cluster of several functionals (PBE0, B1B95, PW6B95, and TPSS25B95) that perform about equally well; if main-group thermochemical performance is additionally considered, then B1B95 and PW6B95 emerge as the best performers. TPSS25B95 and TPSS33B95 offer attractive performance compromises if weak interactions and main-group barrier heights, respectively, are also important. In the ab-initio calculations, basis set superposition errors (BSSE) can be greatly reduced by ensuring that the metal spd shell has sufficient radial flexibility in the high-exponent range. Optimal HF percentages in hybrid functionals depend on the class of systems considered, increasing from anions to neutrals to cations to main-group barrier heights; transition-metal barrier heights represent an intermediate situation. The use of meta-GGA correlation functionals appears to be quite beneficial.

Journal Article↗