Improving women’s quality of care for cardiovascular disease and diabetes: the feasibility and desirability of stratified reporting of objective performance measures

2003 ◽  
Vol 13 (4) ◽  
pp. 150-157 ◽  
Author(s):  
Chloe E Bird ◽  
Allen Fremont ◽  
Steven Wickstrom ◽  
Arlene S Bierman ◽  
Elizabeth McGlynn
Keyword(s):  
Cardiovascular Disease ◽  
Quality Of Care ◽  
Performance Measures ◽  
Objective Performance ◽  
Objective Performance Measures

Quality of care assessment in acute cardiac care

2021 ◽  
pp. 54-62
Author(s):  
Fiona Ecarnot ◽  
François Schiele
Keyword(s):  
Cardiovascular Disease ◽  
Quality Of Care ◽  
Performance Measures ◽  
Quality Measures ◽  
Cardiac Care ◽  
Composite Measures ◽  
Care Assessment ◽  
Measuring Outcomes ◽  
Acute Cardiac Care

This chapter will describe the use of performance measures and quality measures in the assessment of the quality of care delivered to patients with acute cardiovascular disease. It gives a brief recap of the major landmarks in the development of the use of performance measures, and goes on to explain the different approaches to measuring processes of care and to measuring outcomes. The utility and construction of composite measures is also described.

Improving service operations: linking safety culture to hospital performance

2017 ◽  
Vol 28 (1) ◽  
pp. 57-84 ◽  
Author(s):  
Gregory N. Stock ◽  
Kathleen L. McFadden
Keyword(s):  
Patient Safety ◽  
Performance Measures ◽  
Safety Culture ◽  
Linear Regression Analysis ◽  
Patient Safety Culture ◽  
Hospital Performance ◽  
Data Set ◽  
Content Type ◽  
Objective Performance ◽  
Objective Performance Measures

Purpose The purpose of this paper is to examine the relationship between patient safety culture and hospital performance using objective performance measures and secondary data on patient safety culture. Design/methodology/approach Patient safety culture is measured using data from the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture. Hospital performance is measured using objective patient safety and operational performance metrics collected by the Centers for Medicare and Medicaid Services (CMS). Control variables were obtained from the CMS Provider of Service database. The merged data included 154 US hospitals, with an average of 848 respondents per hospital providing culture data. Hierarchical linear regression analysis is used to test the proposed relationships. Findings The findings indicate that patient safety culture is positively associated with patient safety, process quality and patient satisfaction. Practical implications Hospital managers should focus on building a stronger patient safety culture due to its positive relationship with hospital performance. Originality/value This is the first study to test these relationships using several objective performance measures and a comprehensive patient safety culture data set that includes a substantial number of respondents per hospital. The study contributes to the literature by explicitly mapping high-reliability organization (HRO) theory to patient safety culture, thereby illustrating how HRO theory can be applied to safety culture in the hospital operations context.

Abstract WP237: Improved Thrombolysis Rates and Quality of Care for Stroke Patients Through a Provincial Emergency Department Quality Improvement Initiative

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Devin R Harris ◽  
Robert Stenstrom ◽  
Eric Grafstein ◽  
Mark Collison ◽  
Grant Innes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Performance Measures ◽  
Large Scale ◽  
Primary Outcome ◽  
Baseline Data ◽  
Quality Improvement Initiative ◽  
Stroke Patients

Background: The care of stroke patients in the emergency department (ED) is time sensitive and complex. We sought to improve quality of care for stroke patients in British Columbia (B.C.), Canada, emergency departments. Objectives: To measure the outcomes of a large-scale quality improvement initiative on thrombolysis rates and other ED performance measures. Methods: This was an evaluation of a large-scale stroke quality improvement initiative, within ED’s in B.C., Canada, in a before-after design. Baseline data was derived from a medical records review study performed between December 1, 2005 to January 31, 2007. Adherence to best practice was determined by measuring selected performance indicators. The quality improvement initiative was a collaboration between multidisciplinary clinical leaders within ED’s throughout B.C. in 2007, with a focus on implementing clinical practice guidelines and pre-printed order sets. The post data was derived through an identical methodology as baseline, from March to December 2008. The primary outcome was the thrombolysis rate; secondary outcomes consisted of other ED stroke performance measures. Results: 48 / 81 (59%) eligible hospitals in B.C. were selected for audit in the baseline data; 1258 TIA and stroke charts were audited. For the post data, 46 / 81 (57%) acute care hospitals were selected: 1199 charts were audited. The primary outcome of the thrombolysis rate was 3.9% (23 / 564) before and 9.3% (63 / 676) after, an absolute difference of 5.4% (95% CI: 2.3% - 7.6%; p=0.0005). Other measures showed changes: administration of aspirin to stroke patients in the ED improved from 23.7% (127 / 535) to 77.1% (553 / 717), difference = 53.4% (95% CI: 48.3% - 58.1%; p=0.0005); and, door to imaging time improved from 2.25 hours (IQR = 3.81 hours) to 1.57 hours (IQR 3.0), difference = 0.68 hours (p=0.03). Differences were found in improvements between large and small institutions, and between health regions. Conclusions: Implementation of a provincial emergency department quality improvement initiative showed significant improvement in thrombolysis rates and adherence to other best practices for stroke patients. The specific factors that influenced improvement need to be further explored.

Abstract 121: Testing Frequency Of Guideline-recommended Diabetes Performance Measures In A Cohort Of Post-acute Myocardial Infarction (AMI) Diabetics.

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Sood Kisra ◽  
John Spertus ◽  
Faraz Kureshi ◽  
Philip G Jones ◽  
Mikhail Kosiborod ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Quality Of Care ◽  
Performance Measures ◽  
High Risk Group ◽  
Diabetic Patients ◽  
Testing Frequency ◽  
Patient Reported ◽  
Using Data

Background: Diabetes mellitus (DM) is common among patients hospitalized with acute myocardial infarction (AMI). Although guideline-supported performance measures exist to improve care for each condition, prior work assessing the quality of care for diabetic patients after AMI has focused only on adherence to CAD performance measures. The quality of diabetic care these patients’ receive is unknown. Methods: Using data from a prospective AMI registry (TRIUMPH), we identified patients with known DM and examined whether DM-focused performance measures had been applied over the 12 months after discharge. We focused upon 3 DM guideline-supported performance measures: a dilated eye exam, detailed foot exam, and HgbA1C testing. For this analysis, we conducted univariate statistics to describe the frequencies with which diabetics reported receiving these DM performance measures and 4 CAD performance measures at their 12-month interview. Results: Among 1,343 patients with a known diagnosis of diabetes presenting with an AMI, a total of 791 (58.9%) completed the 12-month follow up interview. The mean age (SD) of the analytic cohort was 6111 years, with 60% being males and 63% Caucasian. The frequencies of reported receipt among the examined DM and CAD performance measures ranged from 57.3%- 82.2%, with ASA being the most common and a dilated eye exam being the least (Figure). Only 47% of patients reported receiving all three DM performance measures over the past 12 months, while 41.1% reported receiving either one or two, and 12% reported receiving none. Conclusion: In a large, multi-center cohort of diabetic AMI survivors we found that patient-reported receipt of 3 DM and 4 CAD performance measures is sub-optimal and there is significant room for improvement. Novel strategies and approaches for assessing the quality of care delivered to post-AMI diabetics in a multidimensional fashion remains vital for improving care and outcomes in this high-risk group of patients. Characters: 1,683 + figure 500. Limit 2,500

The Journey From Development to Appraisal

2019 ◽  
pp. 327-342
Author(s):  
Tracy M. Maylett
Keyword(s):  
Performance Management ◽  
Performance Appraisal ◽  
Performance Measures ◽  
Past Performance ◽  
360 Feedback ◽  
Objective Performance ◽  
Objective Performance Measures ◽  
Performance Appraisal Process ◽  
Measures Of Performance

This case study describes an initiative to change a long-standing performance management process at a large manufacturing facility within General Mills that emphasized the attainment of objective performance measures (the “what” of performance) to one that also included the “how” of goal achievement. The organization embarked on a 3-year pilot evaluation of the use of 360 Feedback as a possible solution to replace or supplement their traditional single-source (supervisor) performance appraisal process. The two systems ran in parallel using 140 randomly selected employees. Results showed little correlation between the what measures of performance from the traditional appraisals and the how data collected using the 360 Feedback, supporting the view that job performance should be viewed as requiring both aspects of evaluation, using different methods of assessment. Ultimately, the organization maintained both systems but integrated 360 Feedback into the traditional appraisals as well, creating complementary processes that looked “forward” (development) and “past” (performance).

P3415Will less developed countries be capable of giving high-quality universal coverage to cardiovascular disease survivors? Results from a national health survey, Chile ENS 2016–2017

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Quality Of Care ◽  
National Health ◽  
Health Survey ◽  
Universal Coverage ◽  
National Health Survey ◽  
High Quality

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)

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