scholarly journals Incentives and Big E Engagement

2017 ◽  
Vol 31 (6) ◽  
pp. 462-464 ◽  
Author(s):  
Paul E. Terry
Keyword(s):  
Health Promotion ◽  
Quality Improvement ◽  
Financial Incentives ◽  
Optimal Performance ◽  
Standard Work ◽  
State Of Mind ◽  
Extrinsic Motivators ◽  
Improvement Methodologies ◽  
Best Fit

The kind of engagement industrial psychologists have shown can produce optimal performance relates more to a state of mind than to increasing participation in programs or motivating a workforce with financial incentives. In the context of quality improvement methodologies, the health promotion profession has yet to discover when, where and how large financial incentives should be and how they best fit in our processes. That is, there is no “standard work” for the use of extrinsic motivators. Yet, to argue against incentives given evidence to date has more to do with polemics than science.

Setting the standard for healthy eating: Continuous quality improvement for health promotion at Nova Scotia Health

2020 ◽  
Vol 34 (1) ◽  
pp. 49-55
Author(s):  
Laura J. Kennedy ◽  
Nathan G. A. Taylor ◽  
Taylor Nicholson ◽  
Emily Jago ◽  
Brenda L. MacDonald ◽  
...  
Keyword(s):  
Health Promotion ◽  
Quality Improvement ◽  
Nova Scotia ◽  
Healthy Eating ◽  
Continuous Quality Improvement ◽  
Healthcare Organizations ◽  
Quality Improvement Process ◽  
Continuous Quality ◽  
The Status ◽  
Collaborative Efforts

Healthcare organizations engage in continuous quality improvement to improve performance and value-for-performance, but the pathway to change is often rooted in challenging the way things are “normally” done. In an effort to propel system-wide change to support healthy eating, Nova Scotia Health developed and implemented a healthy eating policy as a benchmark to create a food environment supportive of health. This article describes the healthy eating policy and its role as a benchmark in the quality improvement process. The policy, rooted in health promotion, sets a standard for healthy eating and applies to stakeholders both inside and outside of health. We explain how the policy offers nutrition but also cultural benchmarks around healthy eating, bringing practitioners throughout Nova Scotia Health together and sustaining collaborative efforts to improve upon the status quo.

Targeted reduction in neurosurgical laboratory utilization: resident-led effort at a single academic institution

2014 ◽  
Vol 120 (1) ◽  
pp. 173-177 ◽  
Author(s):  
Seunggu J. Han ◽  
Rajiv Saigal ◽  
John D. Rolston ◽  
Jason S. Cheng ◽  
Catherine Y. Lau ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Financial Incentives ◽  
Laboratory Tests ◽  
Medical Center ◽  
Hospital Setting ◽  
Cost Savings ◽  
Fiscal Year ◽  
Incentive Program ◽  
Neurosurgical Patients

Object Given economic limitations and burgeoning health care costs, there is a need to minimize unnecessary diagnostic laboratory tests. Methods The authors studied whether a financial incentive program for trainees could lead to fewer unnecessary laboratory tests in neurosurgical patients in a large, 600-bed academic hospital setting. The authors identified 5 laboratory tests that ranked in the top 13 of the most frequently ordered during the 2010–2011 fiscal year, yet were least likely to be abnormal or influence patient management. Results In a single year of study, there was a 47% reduction in testing of serum total calcium, ionized calcium, chloride, magnesium, and phosphorus. This reduction led to a savings of $1.7 million in billable charges to health care payers and $75,000 of direct costs to the medical center. In addition, there were no significant negative changes in the quality of care delivered, as recorded in a number of metrics, showing that this cost savings did not negatively impact patient care. Conclusions Engaging physician trainees in quality improvement can be successfully achieved by financial incentives. Through the resident-led quality improvement incentive program, neurosurgical trainees successfully reduced unnecessary laboratory tests, resulting in significant cost savings to both the medical center and the health care system. Similar programs that engage trainees could improve the value of care being provided at other academic medical centers.

scholarly journals Could health information systems enhance the quality of Aboriginal health promotion? A retrospective audit of Aboriginal health programs in the Northern Territory of Australia

2020 ◽  
Author(s):  
Nikki Ann Percival ◽  
Priscilla Boucher ◽  
Kathleen Conte ◽  
Kate Robertson ◽  
Julie Cook
Keyword(s):  
Health Promotion ◽  
Quality Improvement ◽  
Information Systems ◽  
Health Information ◽  
Aboriginal Health ◽  
Health Information Systems ◽  
Online System ◽  
Retrospective Audit ◽  
Potential Benefits

Abstract Background: In Australia, health services are seeking innovative ways to utilize data stored in health information systems to report on, and improve, health care quality and health system performance for Aboriginal Australians. However, there is little research about the use of health information systems in the context of Aboriginal health promotion. In 2008, the Northern Territory’s publicly funded healthcare system introduced the Quality Improvement Program Planning System (QIPPS) as the centralized online system for recording information about health promotion programs. The purpose of this study was to explore the potential for utilizing data stored in QIPPS to report on quality of Aboriginal health promotion, using chronic disease prevention programs as exemplars. We identify the potential benefits and limitations of health information systems for enhancing Aboriginal health promotion. Methods: A retrospective audit was undertaken on a sample of health promotion projects delivered between 2013 and 2016. A validated, paper-based audit tool was used to extract information stored in the QIPPS online system and report on Aboriginal health promotion quality. Simple frequency counts were calculated for dichotomous and categorical items. Text was extracted and thematically analyzed to describe community participation processes and strategies used in Aboriginal health promotion. Results: 39 Aboriginal health promotion projects were included in the analysis. 34/39 projects recorded information pertaining to the health promotion planning phases, such as statements of project goals, ‘needs assessment’ findings, and processes for consulting Aboriginal people in the community. Evaluation findings were reported in approximately one third of projects and mostly limited to a recording of numbers of participants. For almost half of the projects analyzed, community participation strategies were not recorded. Conclusion: This is the first Australian study to shed light on the feasibility of utilizing data stored in a purposefully designed health promotion information system. Data availability and quality were limiting factors for reporting on Aboriginal health promotion quality. Based on our learnings of QIPPS, strategies to improve the quality and accuracy of data entry together with the use of quality improvement approaches are needed to reap the potential benefits of future health promotion information systems.

Quality of Care: Performance Measurement and Quality Improvement in Clinical Practice

2017 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Performance Measurement ◽  
Financial Incentives ◽  
Clinical Performance ◽  
Care Delivery ◽  
The United States ◽  
Technological Advancement

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This chapter contains 56 references.

Quality of Care: Performance Measurement and Quality Improvement in Clinical Practice

2015 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Performance Measurement ◽  
Financial Incentives ◽  
Clinical Performance ◽  
Care Delivery ◽  
The United States ◽  
Technological Advancement

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This chapter contains 56 references.

scholarly journals Adjudicating Traditional Wellness

2020 ◽  
Vol 34 (4) ◽  
pp. 344-348
Author(s):  
Paul E. Terry
Keyword(s):  
Health Promotion ◽  
Quality Improvement ◽  
Physical Health ◽  
Health Assessment ◽  
Educational Programs ◽  
Worksite Health Promotion ◽  
Wellness Program ◽  
Consensus Definition ◽  
Worksite Health ◽  
Physical Health Domain

There is no consensus definition for “traditional wellness” but in worksite health promotion, it usually means the wellness program is a health assessment and/or health screening offering followed by some educational programs, usually in the physical health domain. Using the term traditional wellness may belie an unawareness about or lack of appreciation for the quality improvement principles that are as applicable to the health of a profession as they are to the growth of an organization. This editorial examines how the use of the term traditional wellness is a reflection on our professional zeitgeist. Five ideas that attempt to explain misunderstandings about differing approaches to worksite health promotion are offered along with 5 ways we may be able to make peace with traditional wellness.

scholarly journals Working with lay midwives to improve the detection of neonatal complications in rural Guatemala

2020 ◽  
Vol 9 (1) ◽  
pp. e000775
Author(s):  
Michel Juarez ◽  
Yolanda Juarez ◽  
Enma Coyote ◽  
Tony Nguyen ◽  
Corey Shaw ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mobile Health ◽  
Financial Incentives ◽  
Warning Signs ◽  
Level Of Care ◽  
Neonatal Complications ◽  
Neonatal Deaths ◽  
Home Based ◽  
Improvement Interventions ◽  
Lay Midwives

BackgroundGlobally most neonatal deaths occur within the first week of life and in low-income and middle-income countries. Strengthening health system linkages for frontline providers—such as lay midwives providing home-based obstetrical care—may improve neonatal outcomes in these settings. Here, we conducted a quality improvement study to increase the detection of neonatal complications by lay midwives in rural Guatemala, thereby increasing referrals to a higher level of care.MethodsA quality improvement team in Guatemala reviewed drivers of neonatal health services provided by lay midwives. Improvement interventions included training on neonatal warning signs, optimised mobile health technology to standardise assessments and financial incentives for providers. The primary quality outcome was the rate of neonatal referral to a higher level of care.ResultsFrom September 2017 to September 2018, participating midwives attended 869 home deliveries and referred 80 neonates to a higher level of care. A proportion control chart, using the preintervention period from January to September 2017 as the baseline, showed an increase in the referral rate of all births from 1.5% to 9.9%. Special cause was obtained in January 2018 and sustained except for May 2018. The proportion of neonates receiving assessments by midwives in the first week of life increased to >90%. A trend toward an increasing number of days between neonatal deaths did not attain special cause.ConclusionsStructured improvement interventions, including mobile health decision support and financial incentives, significantly increased the detection of neonatal complications and referral of neonates to higher levels of care by lay midwives operating in rural home-based settings in Guatemala. The results show the value of improving the integration of lay midwives and other first responders into neonatal systems of care in low-resource settings.

scholarly journals Do workplace health-promotion interventions targeting employees with poor health reduce sick-leave probability and disability rates?

2020 ◽  
pp. 140349482094654
Author(s):  
Roy A. Nielsen ◽  
Tove I. Midtsundstad
Keyword(s):  
Health Promotion ◽  
Sick Leave ◽  
Labour Market ◽  
Sickness Absence ◽  
Older Workers ◽  
Financial Incentives ◽  
Disability Pension ◽  
Workplace Health Promotion ◽  
Workplace Health ◽  
Health Promotion Interventions

Aims: This study aimed to investigate whether introducing workplace health-promotion interventions targeting employees with health problems or reduced work ability affected overall sick leave and disability risk. Methods: The study population comprised data from an establishment survey from 2010 identifying who had introduced workplace health promotion (the intervention) linked to register data on all employees and their sickness absence and disability pension uptake from 2000 through 2010. Results: Interventions had moderate effects due to varying efficacy in different parts of the labour market. Intervention success was more likely among white-collar workers (e.g. in public administration) compared to blue-collar workers (e.g. in manufacturing), probably due to variations in both organisational and technological constraints. Effects were small among men and moderate among older workers, particularly among women. Overall, disability risk reduction was accompanied by an increase in sickness absence. Sometimes, sickness absence increased in groups with no change in disability risk, suggesting that presenteeism in one group may increase absenteeism in other groups. Conclusions: Introducing workplace health-promotion interventions may prolong work careers in some labour-market segments. Financial incentives for Norwegian establishments to continue offering workplace health-promotion interventions may be improved, given the current financial model for disability pension and sickness benefits.

Applying quality improvement methodologies to decrease the time-to-activation of new clinical trials at an NCI-designated comprehensive cancer center.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 296-296
Author(s):  
Timothy J Brown ◽  
Erin Fenske Williams ◽  
Patrice Griffith ◽  
Asal Shoushtari Rahimi ◽  
Rhonda Oilepo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Quality Improvement ◽  
Six Sigma ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Process Map ◽  
Decision Points ◽  
Improvement Methodologies ◽  
Six Sigma Methodology ◽  
Pass Through

296 Background: Initiating a new clinical trial is burdensome and complex. The time to activate a clinical trial can directly affect the ability to provide innovative, state-of-the-art care to patients. We sought to understand the process of activating an oncology clinical trial at a matrix National Cancer Institute-designated, comprehensive cancer center. Methods: A multidisciplinary team of stakeholders within the cancer center, university, and affiliate hospitals held a retreat to map out the process of activating a clinical trial from packet receipt to enrollment of the first patient. We applied classical QI and Six Sigma methodology to determine bottlenecks and redundancies in activating a clinical trial. During this process, particular attention was paid to time to pass through each step and perceived barriers and bottlenecks were identified through group discussions. The time to activation was measured from the day the trial packet was received until the time when the trial was open for enrollment. Results: The process map identified 66 steps with 12 decision points to activate a new clinical trial. The following two steps were instituted first: 1) allow parallel scientific committee and institutional review board (IRB) review and 2) allow the clinical research coordination committee to review protocols for feasibility and university interest separate from the IRB approval process. These changes resulted in a mean time-to-activation change from 194 days at baseline to 135 days after these changes were implemented. The committee continues to track the activation time and this frame work is used to identify additional improvement steps. Conclusions: By applying quality improvement methodologies and Six Sigma principles, we were able to redesign redundant aspects of the process of activating a clinical trial at a matrix comprehensive cancer center. This was associated with a reduction of time to activation of trials. More importantly, the process map provides a framework to maintain these gains and implement further changes.

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