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At least 19 recordsLinked to original sources
PubMed1993

Continuous quality improvement. Improving quality in your home care organization.

Total commitment to quality is an important factor in dealing with the competitive market and ensuring future survival. This article details the implementation of a continuous quality improvement program in one home care organization and examines initiation, implementation, and acceleration of the program over a period of just 16 months. It also illustrates how the same organization monitors clinical activities through quality assessment.

Costs and Cost Analysis↗
PubMed1998

Continuous quality improvement, total quality management, and reengineering: one hospital's continuous quality improvement journey.

In recent years, there has been significantly increasing interest in the application of continuous quality improvement (CQI) and total quality management (TQM) in the health care arena. This case analysis is designed to identify and assess the strategies and processes that led to the successful implementation of CQI in the Emergency Care Center at St. Mary's Hospital in Grand Rapids, MI.

Admitting Department, Hospital↗
PubMed1996

Group peer review in psychiatry: the relationship to quality improvement and quality care.

OBJECTIVE: This study sought to elucidate the contribution of peer review groups involving psychiatrists to quality improvement and quality care. METHOD: Audio-taped interviews of groups engaged in peer review were analysed using a qualitative methodology. Participants' views of the ways in which they experienced and conceptualised peer review were explored. RESULTS: The views of participants in peer review groups were analysed, and categories evolved which identified differences in how they perceived the structure and function of group peer review. CONCLUSIONS: Participants in the groups studied perceived peer review as a professional growth forum within a quality improvement framework providing critical review of treatment, continuing education, and a sense of collegiality. Boundaries of acceptable practice were tested and defined. At its best, participation in peer review groups enhanced reflective practice which achieved new understandings of clinical work. In this regard, peer review is seen as a highly desirable method for the maintenance of professional standards.

Attitude of Health Personnel↗
PubMed1983

[Evidence of improved quality of urinary calculus analysis using results of 7 surveys with external quality controls. Improvement in the quality of urinary calculus analysis by establishment of uniform methodological assumptions in urinary calculus analysis laboratories. 2].

Seven quality control surveys confirmed the usefulness of standardized urolith analysis by X-ray diffraction. A method is suggested for tabulating the results of the surveys, which permits qualitative comparison of participating analysis centres. Quality improved considerably after the introduction of the standardized instructions for analysis. The results of the survey with international participants clearly demonstrated the superiority of X-ray diffractometric urolith analysis over polarization microscopical, infrared spectroscopic, differential thermoanalytical and wet chemical analytical techniques.

Humans↗
PubMed1994

Performance improvement through quality improvement teamwork.

Quality improvement teams have the ability to enhance processes that impact care delivery. Organizations must use a framework for documentation and communication of the team's work that is congruent with expectations by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and that nurse executives can apply the expectations to the activities of their departments. The author discusses one such framework, based on 1994 standards, and presents a team report form illustrating communication of the team's efforts using JCAHO terminology.

Humans↗
PubMed1994

A continuous quality improvement project to improve the quality of cervical Papanicolaou smears.

OBJECTIVE: To improve the quality of cervical Papanicolaou smears by continuous quality improvement techniques. METHODS: The study used a Papanicolaou smear data base of over 200,000 specimens collected between June 1988 and December 1992. A team approach employing techniques such as process flow-charting, cause and effect diagrams, run charts, and a randomized trial of collection methods was used to evaluate potential causes of Papanicolaou smear reports with the notation "inadequate" or "less than optimal" due to too few or absent endocervical cells. Once a key process variable (method of collection) was identified, the proportion of Papanicolaou smears with inadequate or absent endocervical cells was determined before and after employment of a collection technique using a spatula and Cytobrush. We measured the rate of less than optimal Papanicolaou smears due to too few or absent endocervical cells. RESULTS: Before implementing the new collection technique fully by June 1990, the overall rate of less than optimal cervical Papanicolaou smears ranged from 20-25%; by December 1993, it had stabilized at about 10%. CONCLUSION: Continuous quality improvement can be used successfully to study a clinical process and implement change that will lead to improvement.

Databases, Factual↗
PubMed1992

Achieving the Health Care Financing Administration limits by quality improvement and quality control. A real-world example.

With the enactment of the Clinical Laboratory Improvement Amendments of 1988 (CLIA 88), the federal government is now using proficiency testing as the primary indicator of laboratory quality. Laboratories with proficiency test failures are now at risk of a variety of harsh penalties including large monetary fines and suspension of operations. To minimize the risk of failed proficiency testing, we initiated a continuous quality improvement program in our general chemistry laboratory in conjunction with the use of a new survey-validated quality control product. This article describes the quality improvement program and our success in reducing the long-term random error in general chemistry. Despite our improvement program, significant analytical errors (greater than 30% of the CLIA limits) still exist in analytes measured by our chemistry analyzer. These errors are present in nearly the same analytes measured by other common chemistry analyzers indicating the need for improvement in their design and manufacture.

Blood Chemical Analysis↗
PubMed1991

Using Q-Probes to improve the quality of laboratory medicine: a quality improvement program of the College of American Pathologists.

This paper will review the reasons for the increasing emphasis on quality assurance in American healthcare and laboratory medicine. This emphasis is driven in part by economic, social and regulatory concerns as well as the traditional commitment to the search for excellence in services provided to patients. The Q-Probes Program of the College of American Pathologists (CAP) represents a response to these pressures and will be described in some detail. The program is based upon the historical success of interlaboratory comparison programs developed and sponsored by the CAP in achieving demonstrable improvement in laboratory performance. These programs are dependent on the gathering of data from large numbers of laboratories in order to establish provisional "benchmarks" of quality practice which serve as a baseline for systematic quality improvement efforts. The Q-Probes Program gathers peer-group specific institutional data concerning defined aspects of quality practice in pathology and laboratory medicine. These highly structured programs provide laboratories and pathology services with a format to collect data for submission to the CAP for analysis and to compare their performance against that of appropriately stratified peer groups. Several representative examples chosen from clinical laboratory medicine and pathology will be presented. We will attempt to demonstrate how individual laboratory and pathology services utilize aggregate data to effect specific changes in practice that lead to improvement in processes of patient care and better patient outcomes.

Blood Specimen Collection↗
PubMedDate not supplied

Implementation of unit-based continuous quality improvement approach to quality management: applying concepts to practice.

This article describes the implementation of unit-based continuous quality improvement approach to quality management and the resultant fostering of autonomy and decision-making among clinical nurses. Restructuring, education and evaluation activities during implementation are described. Nurses in the post-implementation evaluation survey stated that quality of care was improved by unit-based continuous quality improvement. Unit-based continuous quality improvement promotes a high level of clinical nurse involvement as evidenced by quality improvement initiatives and projects completed. Accompanying this involvement, is a system of continuous quality improvement which facilitates patient care improvement.

Decision Making, Organizational↗
PubMed1995

Quality improvement in health care organizations: a general systems perspective.

A systems analysis of healthcare organizations demonstrates that methods for improving quality involve the effective feedback regulation of key organizational performance parameters. Information flow is impaired in dysfunctional healthcare organizations, which often disregard significant clinical problems while preferentially tracking nonclinical indicators and clinical data considered most likely to meet the organization's standards. Such organizations thus achieve "pseudocompliance" with external requirements, but do not systematically work to improve the quality of clinical care or their performance as organizations. Efforts by government agencies and national organizations to foster quality improvement activities have had limited success precisely because local organizations perceive these efforts as externally imposed. Leaders' anxieties about their own and their organizations' autonomy, control, and performance can cause unwillingness to review data indicating performance problems, oversimplification of decision criteria, and reluctance to formulate meaningful conclusions and act on them. Contemporary quality improvement models, such as Continuous Quality Improvement (CQI) and Total Quality Management (TQM), reconnect leaders to their organizations' quality processes by emphasizing the leaders' roles in promoting quality as an organizational value, setting meaningful quality goals, and actively u sing information to improve organizational effectiveness.

Delivery of Health Care↗
PubMed1994

Toward continuous quality improvement in trauma care.

Trauma providers are engaged in a constant struggle to improve quality and to assure positive outcomes in an unpredictable disease process. Traditional quality assurance has been unsuccessful in achieving these goals. Continuous quality improvement methodologies hold promise as the tools to balance quality, outcomes, and patient satisfaction with cost concerns.

Cost Control↗
PubMed1997

A framework for integrated quality improvement.

The importance of maintaining and improving quality is well understood in most health care organizations. This work becomes more challenging as internal and external conditions rapidly change. A quality improvement framework was developed to help clinicians and administrators organize intergrated, multifaceted quality programs that have the flexibility necessary for success in today's fast-paced health care environment.

Case Management↗
PubMed1994

Transition to quality improvement: adapting the quality management plan.

Health care organizations across the country are in different phases of transition from quality assurance to quality improvement. A plan is essential to ensure quality assessment and improvement requirements are met while the organization is in transition. Based on the hospital's commitment to quality improvement, the Division of Nursing at The New York Hospital has built on the strengths of the QA program and begun transition to QI by incorporating the principles of QI and developing quality improvement teams with other disciplines and within nursing.

Joint Commission on Accreditation of Healthcare Or↗
PubMed1994

Continuous improvement, quality control, and cost containment in clinical laboratory testing. Enhancement of physicians' laboratory-ordering practices.

In 1991, the University of Massachusetts Medical Center, in Worcester, developed a model for change by using a program of continuous quality improvement to enhance physicians' laboratory-ordering practices, particularly the test for bleeding times. We describe a model that was developed through a seven-step continuous quality improvement process, and we discuss our success in increasing the appropriateness of ordering the tests for bleeding times while significantly reducing the costs for patients and hospitals. The following factors contributed to the program's success: an advisory structure; presentations to the medical staff; focused feedback sessions; and most important, well-documented guidelines with institutional support for new behavior.

Clinical Laboratory Techniques↗
PubMed1992

The use of continuous quality improvement methods in the development and dissemination of medical practice guidelines.

The federal government is currently supporting the development and dissemination of clinical practice guidelines. Physicians fear that payers who promote guidelines are more interested in reducing variation to control their behavior and contain health care spending than in improving quality of care. There is also apprehension that guidelines will shift the responsibility for quality to parties external to the physician-patient relationship and the local professional community. Continuous quality improvement (CQI) methods provide an avenue for physician responsibility and participation in guideline development which can alleviate these concerns. This article describes the efforts of one health maintenance organization (HMO) to use CQI techniques to mobilize plan physicians to develop, disseminate, and implement practice guidelines in a manner that satisfies the needs of physicians, patients, and the HMO.

Anti-Ulcer Agents↗