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"Quality Assurance, Health Care"
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EQ-5D and the EuroQol Group: Past, Present and Future
Over the period 1987–1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the ‘EQ-5D’. It was designed to measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Initial expansion came, in particular, in the form of new language versions. Their development raised translation and semantic issues, experience with which helped feed into the design of two further instruments, the EQ-5D-5L and the youth version EQ-5D-Y. The expanded usage across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets is outlined. Valuation has been of continued relevance for the Group as this has allowed its instruments to be utilised as part of the economic appraisal of health programmes and their incorporation into health technology assessments. The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal.
Journal Article
Seeking Value
Health indicators in the United States are among the worst in the developed world, even though its health care system is, by a wide margin, the most expensive in the world. It is a disparity that stems from a fragmentation of services and financial arrangements that often prioritize commercial interests over public health.
Seeking Value: Balancing Cost and Quality in Psychiatric Care, a comprehensive volume by the Group for the Advancement of Psychiatry's Mental Health Services Committee, examines the myriad factors that have led to the current state of health care in the United States -- starting with an analysis of the meaning and history of value measurement -- but it does not stop there. It offers a holistic vision for health care reform, one in which psychiatric professionals play a pivotal role.
A section on system interventions tackles traditional models of financing health care and the role of market forces as it considers broad public health strategies, from elimination of administrative waste to integration of care, that can reduce costs and improve population health, with a special emphasis on the interaction between mental and physical health.
Recognizing that these larger-scale interventions require time to bear fruit, the book also explores the ways the psychiatric profession and individual psychiatrists can contribute to a more skill-diverse, collaborative, activist, value-conscious, and visionary specialty.
Several chapters also identify public policy issues and cultural constructs that go beyond the typical role of clinicians and health care administrators, but that have the potential to impact population health in significant ways, illustrating how different choices could result in remarkable improvements in social well-being. The incorporation of healthy practices in the workplace, efforts to mitigate the impact of climate change, and the elimination of counterproductive incarceration practices all feature in this discussion.
Exhaustive in approach, the book aims to spur thought, conversation, and action to improve value in the services the psychiatric profession provides and the systems in which it operates. Its clear and compelling message will equip readers to develop an advocacy agenda that will resonate with nonmedical stakeholders and the practical strategies needed to see it realized.
eBook
Quality management and managerialism in healthcare : a critical historical survey
\"Quality Management and Managerialism in Healthcare creates a comprehensive and systematic international survey of various perspectives on healthcare quality management together with some of their most pertinent critiques. Chapter one starts with a general discussion of the factors that drove the introduction of management paradigms into public sector and health management contexts in the mid to late 1980s. Chapter two explores the rise of risk awareness in medicine; which, prior to the 1980s, stood largely in isolation to the implementation of managerial performance targets. Chapter three investigates the widespread adoption of performance management and clinical governance frameworks during the 1980s and 1990s. This is followed by Chapters four and five which examine systems based models of patient safety and the evidence-based medicine movement as exemplars of managerial perspectives on healthcare quality. Chapter six discusses potential future avenues for the development of alternative perspectives on quality of care which emphasise workforce involvement. The book concludes by reviewing the factors which have underpinned the managerialist trajectory of healthcare management over the past decades and explores the potential impact of nascent technologies such as 'connected health' and 'telehealth' on future developments\"-- Provided by publisher.
Book
Health systems strengthening, universal health coverage, health security and resilience
Global and national initiatives focused on health systems strengthening, universal health coverage, health security, and resilience suffer when these terms are not well understood or believed to be different ways of saying the same thing. Conceptual clarity is essential for a systematic approach to policy-making. Confusion and inefficiency arise when health system strengthening is defined as an objective and also when universal health coverage, health security or resilience are described as separate programmes to be implemented. So here is a simple guide: health system strengthening is what they do; universal health coverage, health security and resilience are what they want.
Journal Article
Depression in primary care : evidence and practice
\"Although depression is a major cause of illness and disability, the quality of care offered is often poor. Research evidence demonstrating how the quality of primary care can be improved is dispersed in different academic journals and written in technical jargon. Depression in Primary Care: Evidence and Practice summarizes this research in a clear and useable format. This collection of high quality reviews of research evidence takes the form of a series of clinical and economic evaluations. Each provides a clear summary of the best evidence from trials and an accessible 'how to do it' guide, written by international experts. Global approaches towards the organization and delivery of primary care for depression are presented, from the UK, North America, Europe and the developing world. An important source of practical guidance about how to implement quality improvement programs in clinical practice, this book will assist practitioners, researchers and policy makers alike. - Combines clear evidence summaries with a simple and practical guide about how to implement quality improvement programmes in practice - Prepared by international experts and of interest and relevance in all countries and healthcare settings - Addresses a major healthcare priority identified by the World Health Organization, US Agency for Healthcare Research and UK National Institute for Clinical Excellence\"--Provided by publisher.
Book
Pursuing the Triple Aim: The First 7 Years
Context: In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously \"improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations.\" IHI and its close colleagues had determined that both individual and societal changes were needed. Methods: In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and those that did not, we were able to develop an ex post theory of what is needed for an organization or community to successfully pursue the Triple Aim. Findings: Drawing on our 7 years of experience, we describe the 3 major principles that guided the organizations and communities working on the Triple Aim: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. Conclusions: The concept of the Triple Aim is now widely used, because of IHI's work with many organizations and also because of the adoption of the Triple Aim as part of the national strategy for US health care, developed during the implementation of the Patient Protection and Affordable Care Act of 2010. Even those organizations working on the Triple Aim before IHI coined the term found our concept to be useful because it helped them think about all 3 dimensions at once and organize their work around them.
Journal Article
A factory of one : applying lean principles to banish waste and improve your personal performance
\"The same Lean principles that are helping hospitals eliminate waste and improve efficiencies are applicable to individuals working in healthcare. This book not only provides the tools to alleviate the obvious symptoms of inefficiency but also demonstrates how to find the root causes underlying that inefficiency. It presents a practical, step-by-step approach to applying Lean principles to individuals, including real-world examples that illustrate how these principles have been applied in the healthcare industry\"-- Provided by publisher.
Book
Improving Health Care Quality
Learn how to improve the quality of health care offered by your institution using data you already have
Improving Health Care Quality: Case Studies with JMP ® teaches readers how to systematically identify problems, collect and interpret data, and solve issues in the real world. Relying on JMP ® software, the authors walk readers through the process of applying quality improvement techniques to real-life health care problems.
The case studies provided in the book vary significantly and provide a wide-ranging view of the application of quality improvement techniques in the health care field. Studies regarding length of stay of diabetes patients to benchmarking the costs of hip replacement all serve to illuminate and explain the underlying concepts of statistical analysis.
The authors break each case study down into several sections, including:
* Background and Task
* Data and Data Management
* Analysis
* Summary
* Concepts and Tools
* Exercises and Discussion Questions
Each section reinforces the lessons learned in each case study and helps the reader learn to apply statistical data to their own health care quality problems.
eBook