Prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium-based disinfectant on surface contamination and health care outcomes

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

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Evidence of the Impact of Quilts and Quiltmaking on Health and Health-Care Outcomes

Quilts and Health ◽

10.2307/j.ctt2005x60.6 ◽

2018 ◽

pp. 7-17

Keyword(s):

Health Care ◽

Health Care Outcomes ◽

Care Outcomes ◽

The Impact

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Return on investment in healthcare leadership development programs

Leadership in Health Services ◽

10.1108/lhs-02-2017-0005 ◽

2018 ◽

Vol 31 (1) ◽

pp. 77-97 ◽

Cited By ~ 7

Author(s):

Maya M. Jeyaraman ◽

Sheikh Muhammad Zeeshan Qadar ◽

Aleksandra Wierzbowski ◽

Farnaz Farshidfar ◽

Justin Lys ◽

...

Keyword(s):

Health Care ◽

Leadership Development ◽

Development Programs ◽

Leadership Development Programs ◽

Content Type ◽

Health Care Outcomes ◽

Leadership Quality ◽

Care Outcomes ◽

Evaluative Instrument ◽

The Impact

Purpose Strong leadership has been shown to foster change, including loyalty, improved performance and decreased error rates, but there is a dearth of evidence on effectiveness of leadership development programs. To ensure a return on the huge investments made, evidence-based approaches are needed to assess the impact of leadership on health-care establishments. As a part of a pan-Canadian initiative to design an effective evaluative instrument, the purpose of this paper was to identify and summarize evidence on health-care outcomes/return on investment (ROI) indicators and metrics associated with leadership quality, leadership development programs and existing evaluative instruments. Design/methodology/approach The authors performed a scoping review using the Arksey and O’Malley framework, searching eight databases from 2006 through June 2016. Findings Of 11,868 citations screened, the authors included 223 studies reporting on health-care outcomes/ROI indicators and metrics associated with leadership quality (73 studies), leadership development programs (138 studies) and existing evaluative instruments (12 studies). The extracted ROI indicators and metrics have been summarized in detail. Originality/value This review provides a snapshot in time of the current evidence on ROI indicators and metrics associated with leadership. Summarized ROI indicators and metrics can be used to design an effective evaluative instrument to assess the impact of leadership on health-care organizations.

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The Impact of Information Technology on Emergency Health Care Outcomes

10.3386/w7887 ◽

2000 ◽

Cited By ~ 7

Author(s):

Susan Athey ◽

Scott Stern

Keyword(s):

Health Care ◽

Information Technology ◽

Health Care Outcomes ◽

Emergency Health Care ◽

Care Outcomes ◽

The Impact

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The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review

JMIR Medical Informatics ◽

10.2196/30432 ◽

2021 ◽

Vol 9 (11) ◽

pp. e30432

Author(s):

Tobias Hodgson ◽

Andrew Burton-Jones ◽

Raelene Donovan ◽

Clair Sullivan

Keyword(s):

Systematic Review ◽

Health Care ◽

Patient Care ◽

Electronic Medical Records ◽

Medical Records ◽

Health Care Outcomes ◽

Quadruple Aim ◽

Care Outcomes ◽

Clinical Variation ◽

The Impact

Background The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. Objective A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. Methods Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. Results Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. Conclusions The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

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The Impact of Information Technology on Emergency Health Care Outcomes

The RAND Journal of Economics ◽

10.2307/3087465 ◽

2002 ◽

Vol 33 (3) ◽

pp. 399 ◽

Cited By ~ 108

Author(s):

Susan Athey ◽

Scott Stern

Keyword(s):

Health Care ◽

Information Technology ◽

Health Care Outcomes ◽

Emergency Health Care ◽

Care Outcomes ◽

The Impact

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Interrupted time-series analysis: studying trends in neurosurgery

Neurosurgical FOCUS ◽

10.3171/2015.9.focus15374 ◽

2015 ◽

Vol 39 (6) ◽

pp. E6

Author(s):

Ricky H. Wong ◽

Fabrice Smieliauskas ◽

I-Wen Pan ◽

Sandi K. Lam

Keyword(s):

Health Care ◽

Time Series ◽

Time Series Analysis ◽

Interrupted Time Series ◽

Interrupted Time Series Analysis ◽

Services Research ◽

Health Care Outcomes ◽

Series Analysis ◽

Care Outcomes ◽

The Impact

OBJECT Neurosurgery studies traditionally have evaluated the effects of interventions on health care outcomes by studying overall changes in measured outcomes over time. Yet, this type of linear analysis is limited due to lack of consideration of the trend’s effects both pre- and postintervention and the potential for confounding influences. The aim of this study was to illustrate interrupted time-series analysis (ITSA) as applied to an example in the neurosurgical literature and highlight ITSA’s potential for future applications. METHODS The methods used in previous neurosurgical studies were analyzed and then compared with the methodology of ITSA. RESULTS The ITSA method was identified in the neurosurgical literature as an important technique for isolating the effect of an intervention (such as a policy change or a quality and safety initiative) on a health outcome independent of other factors driving trends in the outcome. The authors determined that ITSA allows for analysis of the intervention’s immediate impact on outcome level and on subsequent trends and enables a more careful measure of the causal effects of interventions on health care outcomes. CONCLUSIONS ITSA represents a significant improvement over traditional observational study designs in quantifying the impact of an intervention. ITSA is a useful statistical procedure to understand, consider, and implement as the field of neurosurgery evolves in sophistication in big-data analytics, economics, and health services research.

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