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Measuring comparative hospital performance.

Leading healthcare provider organizations now use a "balanced scorecard" of performance measures, expanding information reviewed at the governance level to include financial, customer, and internal performance information, as well as providing an opportunity to learn and grow to provide better strategic guidance. The approach, successfully used by other industries, uses competitor data and benchmarks to identify opportunities for improved mission achievement. This article evaluates one set of nine multidimensional hospital performance measures derived from Medicare reports (cash flow, asset turnover, mortality, complications, length of inpatient stay, cost per case, occupancy, change in occupancy, and percent of revenue from outpatient care). The study examines the content validity, reliability and sensitivity, validity of comparison, and independence and concludes that seven of the nine measures (all but the two occupancy measures) represent a potentially useful set for evaluating most U.S. hospitals. This set reflects correctable differences in performance between hospitals serving similar populations, that is, the measures reflect relative performance and identify opportunities to make the organization more successful.

Benchmarking↗
PubMed2002

NHS Direct audited.

Explore the source record for details and available documents.

Consumer Behavior↗
PubMed2000

Let's audit the HMOs!

Explore the source record for details and available documents.

Health Maintenance Organizations↗
PubMed2001

Improving competitiveness through performance-measurement systems.

Parallels exist between the competitive pressures felt by U.S. manufacturers over the past 30 years and those experienced by healthcare providers today. Increasing market deregulation, changing government policies, and growing consumerism have altered the healthcare arena. Responding to similar pressures, manufacturers adopted a strategic orientation driven by customer needs and expectations that led them to achieve high performance levels and surpass their competition. The adoption of integrated performance-measurement systems was instrumental in these firms' success. An integrated performance-measurement model for healthcare organizations can help to blend the organization's strategy with the demands of the contemporary healthcare environment. Performance-measurement systems encourage healthcare organizations to focus on their mission and vision by aligning their strategic objectives and resource-allocation decisions with customer requirements.

Decision Making, Organizational↗
PubMed2006

Recombinant factor VIIa in the management of postpartum bleeds: an audit of clinical use.

BACKGROUND: This paper presents an analysis of 25 patient cases in which recombinant factor VIIa was used in the management of postpartum hemorrhage, including severe and/or life-threatening bleeds. Anecdotal experiences in the empirical use of this agent are described and dosing regimens, effects on bleeding, and safety data are presented. METHODS: Data were extracted from the international, internet-based, voluntary registry, haemostasis.com. Search results were manually cross-checked against monthly summary reports and cases of confirmed postpartum hemorrhage were analyzed by the authors. Case providers were contacted individually to approve the use of their cases, supply any missing data, and validate the data already held. RESULTS: Of 43 reported gynecological admissions for hemorrhage, 13 were excluded as they did not relate to childbirth, and 5 due to insufficient data. The remaining 25 records, all associated with postpartum hemorrhage, were submitted by 14 doctors from 5 countries. Following administration of recombinant factor VIIa, bleeding stopped in 18 cases (72%), markedly decreased in 2 (8%), and decreased in 4 (16%). Bleeding increased following recombinant factor VIIa administration in only 1 patient (4%). Requirements for replacement blood products and crystalloids/colloids were also greatly curtailed. A full recovery was achieved by most patients (22/25, 88%) with few complications, even when recombinant factor VIIa was administered as salvage therapy. There were no thrombotic complications associated with recombinant factor VIIa administration. CONCLUSIONS: This review provides the largest aggregate of cases in which recombinant factor VIIa has been used to control obstetrical bleeding. A review of these cases suggests that this agent may be a useful and safe adjunctive therapy in the management of postpartum hemorrhage.

Adult↗
PubMed1993

Quality assurance and internal organizational communications.

Reviews the relationship between internal communication in organizations and the effective delivery of service. Illustrates how quality internal communications can reduce the levels of uncertainty experienced by staff, especially at times of change, and describes a methodology--the communication audit--whereby organizations can monitor and evaluate quality in this sphere. Explains the core steps involved in implementing this type of audit and itemizes the main data collection tools.

Forms and Records Control↗