How Do We Align Health Services Research and Quality Improvement?

2020 ◽  
pp. 282-291
Author(s):  
Devika Das ◽  
Lalan Wilfong ◽  
Katherine Enright ◽  
Gabrielle Rocque
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Quality ◽  
Care Delivery ◽  
Care Quality ◽  
Health Care Use ◽  
Semistructured Interview ◽  
Services Research

Quality improvement (QI) initiatives and health services research (HSR) are commonly used to target health care quality. These disciplines are increasingly important because of the movement toward value-based health care as alternative payment and care delivery models drive institutions and investigators to focus on reducing unnecessary health care use and improving care coordination. QI efforts frequently target medical error and/or efficiency of care through the Plan-Do-Study-Act methodology. Within the QI framework, strategies for data display (e.g., Pareto charts, run charts, histograms, scatter plots) are leveraged to identify opportunities for intervention and improvement. HSR is a multidisciplinary field of study that seeks to identify the most effective way to organize, deliver, and finance health care to maximize the quality and value of care at both the individual and population levels. HSR uses a diverse set of quantitative and qualitative methodologies, such as case-control studies, cohort studies, randomized control trials, and semistructured interview/focus group evaluations. This manuscript provides examples of methodologic approaches for QI and HSR, discusses potential challenges associated with concurrent quality efforts, and identifies strategies to successfully leverage the strengths of each discipline in care delivery.

Musculoskeletal healthcare at a Swiss university hospital chiropractic medicine outpatient clinic in 2019: a health services research study

2021 ◽  
Author(s):  
Léonie Hofstetter ◽  
Melanie Häusler ◽  
Malin Mühlemann ◽  
Luana Nyirö ◽  
Daniel Mühlemann ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Quality ◽  
Research Study ◽  
Clinical Care ◽  
Care Quality ◽  
University Hospital ◽  
Services Research

Abstract Background The Balgrist University Hospital in Zurich, Switzerland, is an academic hospital focused on musculoskeletal (MSK) disorders. An integrated chiropractic medicine clinic provides chiropractic care to a broad patient population. Our health services research study aims to advance understanding of chiropractic health care service for quality assurance and health care quality improvement. Methods An observational clinical cohort study at the Balgrist chiropractic medicine clinic in 2019 was performed. The records of all patients with initial visits or returning initial visits (> 3 months since last visit) and their subsequent visits from January 1, 2019 to December 31, 2019, were used to create the study dataset. Data collected included demographic characteristics, diagnoses, imaging data, conservative treatments, surgeries, and other clinical care data. Descriptive statistics were used to summarize data. Results 1844 distinct patients (52% female, mean age 48 ± 17 years) were eligible and included in the study. 1742 patients had a single initial visit, 101 had 2 initial visits, and 1 patient had 3 initial visits during the study period. The most common main diagnoses were: low back pain (41%; 95% CI, 39–43%), neck pain (21%; 19–23%), and thoracic pain (8%; 7–9%). 29% had an acute (< 4 weeks) symptom duration, 10% subacute (4 to 12 weeks), and 52% chronic (> 12 weeks). Patients had a median number of 5 chiropractic visits during their episode of care, with a median care episode duration of 28 days. Only 49% (95% CI, 47–52%) of patient records had a clinical outcome that was extractable from routine clinical practice documentation retrievable from the hospital system. Conclusion Our health services research study provides an initial understanding of the patient characteristics and MSK clinical care delivered in a Swiss outpatient hospital setting and areas for clinical data quality assurance. Deeper insights into health care services and outcomes will help to facilitate a health quality improvement initiative by identifying clinical data and health care quality gaps, and establishing overall aims and targets for improvement.

Challenge to Child Health Services Research: Report From the Committee on Pediatric Health and Health Care Quality Measures

2011 ◽  
Vol 11 (4) ◽  
pp. 257-259 ◽  
Author(s):  
Marie C. McCormick ◽  
Glenn Flores ◽  
Gary L. Freed ◽  
Charles J. Homer ◽  
Kevin B. Johnson ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Child Health Services ◽  
Research Report ◽  
Services Research

scholarly journals Assigning Resources to Health Care Use for Health Services Research

Medical Care ◽  
2009 ◽  
Vol 47 (Supplement) ◽  
pp. S70-S75 ◽  
Author(s):  
Paul A. Fishman ◽  
Mark C. Hornbrook
Keyword(s):  
Health Care ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Use ◽  
Services Research

Rural America: Unique opportunities for health care delivery and health services research.

1989 ◽  
Vol 44 (10) ◽  
pp. 1298-1306 ◽  
Author(s):  
Patrick H. DeLeon ◽  
Mary Wakefield ◽  
Amy J. Schultz ◽  
Jane Williams ◽  
Gary R. VandenBos
Keyword(s):  
Health Care ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Rural America ◽  
Services Research

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

Health Services Research at United HealthCare Corporation: The Role of the Center for Health Care Policy and Evaluation

1996 ◽  
Vol 53 (1_suppl) ◽  
pp. 65-76 ◽  
Author(s):  
Eileen Peterson ◽  
Deborah Shatin ◽  
Douglas Mccarthy
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Services Research ◽  
Health Services ◽  
Health Care Policy ◽  
Research Priorities ◽  
Research Capacity ◽  
Lessons Learned ◽  
Services Research ◽  
And Performance

This article describes collaborative health services research and performance evaluation activities at United HealthCare Corporation, a national health care management services company. We outline the development of a research capacity within our company, the principal data sources used, and the types of research conducted. The importance of health services research within a managed care system is illustrated using two projects as examples. finally, we discuss issues faced by organizations such as ours in defining appropriate research priorities, ensuring health plan participation, and disseminating research findings. Lessons learned should be of interest to health services researchers working in or collaborating with managed care organizations as well as others seeking to understand the dynamics of research in private-sector health care companies.

scholarly journals Quality indicators of dental health care in Serbia

2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health System ◽  
Quality Indicators ◽  
Health Care Quality ◽  
Care Quality ◽  
System Quality ◽  
Quality Health Care ◽  
Quality Health

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.

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