Back to Search
Start Over
Using hospital performance data in quality improvement: the Cleveland Health Quality Choice experience
- Source :
- The Joint Commission journal on quality improvement. 24(7)
- Publication Year :
- 1998
-
Abstract
- Article-at-a-Glance Background Cleveland Health Quality Choice is a regional initiative to assess hospital performance which was implemented in 1989. The project developed and validated CHOICE, a severity adjustment system that includes diagnosis-specific models for medical, surgical, and obstetrical patients which are based on clinical data abstracted from patients' medical records. Methodology Since 1992 Cleveland Health Quality Choice has disseminated semi-annual reports that profile hospital mortality rates, lengths of stay, and cesarean section rates using the CHOICE severity adjustment models. Hospitals receive tabular and graphical representations of hospital outcomes and electronic patient-level data files that can be used to further examine outcomes in clinical subgroups. Results Four case studies illustrate how outcomes data derived from the CHOICE models led to the development of successful hospital programs to decrease lengths of stay, cesarean section rates, and hospital mortality rates. Although each case study reflected a unique approach to process improvement, several common characteristics were observed: (1) establishment of interdisciplinary process improvement teams with senior physician and nursing leadership; (2) detailed review of the process of care to identify modifiable clinical practices likely to affect outcomes; (3) development of practice guidelines based on group consensus or published recommendations that were designed to affect modifiable practices; and (4) aggressive sharing of serial data with individual practitioners. Conclusions Although outcomes data can provide powerful insight on where to target quality improvement efforts, hospitals must identify influential and modifiable clinical practices. Such efforts are most likely to be successful if driven by interdisciplinary work groups, supported by senior clinicians and administrators, and based on locally accepted practice standards.
- Subjects :
- Adult
Male
Quality management
MEDLINE
Annual Reports as Topic
Severity of Illness Index
Organizational Case Studies
Patient satisfaction
Nursing
Pregnancy
Health care
Severity of illness
Medicine
Humans
Hospital Mortality
Coronary Artery Bypass
Institutional Management Teams
Ohio
Quality Indicators, Health Care
Retrospective Studies
business.industry
Cesarean Section
Medical record
Infant, Newborn
General Medicine
Health Care Coalitions
Pneumonia
Length of Stay
Hospitals
Intensive Care Units
Outcome and Process Assessment, Health Care
Patient Satisfaction
Female
business
Working group
Total Quality Management
Subjects
Details
- ISSN :
- 10703241
- Volume :
- 24
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- The Joint Commission journal on quality improvement
- Accession number :
- edsair.doi.dedup.....c75aeeb5a3d68b3f7ee4087701ae5e4b