A self-assessment tool for safety and quality improvement in radiotherapy.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 263-263
Author(s):  
Todd Pawlicki ◽  
Peter Dunscombe ◽  
Eric Ford
Keyword(s):  
Quality Improvement ◽  
Assessment Tool ◽  
Radiation Treatment ◽  
Clinical Performance ◽  
The United States ◽  
Healthcare Research ◽  
Iterative Refinement ◽  
Self Assessment ◽  
Online Tool ◽  
Stage Of Development

263 Background: The radiation treatment community has traditionally had a strong focus on the safety and quality of the care provided to cancer patients. Recent well publicized events in the United States and around the world have served to further sharpen this focus and have resulted in the generation of many reports offering advice and recommendations on how we could do better. While advice is plentiful, practical tools for the on-going improvement of safety and quality in radiotherapy are generally lacking. The online Safety Profile Self-Assessment Tool, described here, is being developed to fill this gap. Methods: The tool was built principally on three foundations: The Agency for Healthcare Research and Quality’s (AHRQ) validated survey tools, an analysis of recommendations in seven recent authoritative documents and the AAPM’s Work Group on the Prevention of Errors “Consensus recommendations for incident learning database structures in radiation oncology”. A core group developed a demonstration version of the tool. Both the content and functionality of this version were extensively discussed and further developed at a Workshop including representatives of ASRT, ASTRO, AAMD and SROA. Iterative refinement of the tool took place after the Workshop. Results: The tool is divided into four major sections: (1) Institutional Culture, (2) Quality Management, (3) Managing Change and Innovation, and (4) Clinical Performance. The fourth section, Clinical Performance, is further subdivided into the major steps in the radiotherapy process. The 90 safety/quality indicators take the form of statements with which the assessor identifies the degree of compliance on a five point Likert scale. An example of a Safety/Quality indicator isClinical staff submits reports of errors and near-misses.The assessor responds to this statement on a scale ranging from “Always” to “Never”. The online tool includes a Safety/Quality Improvement log to facilitate tracking the implementation of remedial actions taken in response to identified system weaknesses. Conclusions: An online tool to facilitate Safety/Quality improvement in Radiotherapy is at an advanced stage of development. The tool will be released for general use in the fall of 2012 and fully evaluated thereafter.

scholarly journals Learning health systems in primary care: a systematic scoping review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Danielle M. Nash ◽  
Zohra Bhimani ◽  
Jennifer Rayner ◽  
Merrick Zwarenstein
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Health Systems ◽  
Scoping Review ◽  
Early Stage ◽  
Point Of Care ◽  
The United States ◽  
Stage Of Development ◽  
Integrated Health ◽  
Google Search

Abstract Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.

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

2021 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Performance Measurement ◽  
Clinical Performance ◽  
The United States ◽  
Performance Measure ◽  
Care Performance

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 review contains 1 figure, 3 tables, and 56 references Keywords: Quality of care, performance measure, quality improvement, clinical practice, sigma six, transparency

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.

A Learning Outcome Inspired Survey Instrument for Assessing the Quality of Continuous Improvement Cycle

2019 ◽  
Vol 15 (2) ◽  
pp. 108-129 ◽  
Author(s):  
Abdallah Namoun ◽  
Ahmad Taleb ◽  
Mohammed Al-Shargabi ◽  
Mohamed Benaida
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Delphi Study ◽  
Assessment Tool ◽  
Survey Instrument ◽  
Assessment Instrument ◽  
Self Assessment ◽  
Continuous Quality ◽  
System Requirements

Measuring the effectiveness of a continuous quality improvement cycle in education is a cumbersome and sophisticated process. This article contributes a comprehensive self-assessment instrument for identifying the strengths and weaknesses of all phases of a continuous quality improvement cycle, including planning, data collection, analysis and reporting, and implementation of improvements. To this end, a four round Delphi study soliciting a total of 23 program quality experts from four universities was conducted. The produced survey instrument contains a total of 50 questions. The instrument may be used by quality experts in education to judge the quality of their continuous quality improvement cycle that endeavours to assess the attainment of learning outcomes in various undergraduate educational programs. Moreover, the instrument could be exploited to infer relevant user and system requirements and guide the development of an automated self-assessment tool aimed at identifying the shortcomings in educational continuous quality improvement cycles.

Evolution of multidisciplinary care: Experience of the National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP).

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 67-67 ◽  
Author(s):  
Eliot Lawrence Friedman ◽  
Paul Morris ◽  
Margaret Currens ◽  
Kathleen M. Castro ◽  
Steven B. Clauser ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Organizational Support ◽  
Patient Navigation ◽  
Assessment Tool ◽  
Multidisciplinary Care ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Integration Of Care

67 Background: A key aim of the NCCCP is to develop and improve the quality of multidisciplinary care (MDC). An assessment tool with nine key elements relevant to MDC structure and operations was developed to assess MDC maturity and set goals for continued quality improvement at individual sites and across the network. Methods: 14 NCCCP sites self-reported MDC assessments for lung, breast, and colorectal cancer in June 2010, 2011, and 2012 using an online reporting tool. Each site evaluated their level of maturity (level 1 = no MDC, level 5 = highly integrated MDC) in nine elements integral to the MDC process. Qualitative review of sites’ responses was also conducted. Results: MDC improvement was most evident in four of nine elements; case planning (CP), physician engagement (PE), integration of care coordination (ICC), and quality improvement (QI). The number of sites at level 3 or greater is reported in the table below. Integration of primary care providers and increased organizational support contributed to improved CP. PE was related to conditions of participation, insuring involvement of appropriate physicians in the MDC. The network focus on patient navigation was demonstrated by increase of ICC. Improvement in QI was related to increased participation of sites in physician and hospital quality initiatives (i.e., QOPI and RQRS), and an NCCCP project aimed at increasing referrals to genetics for patient with breast and colon cancer. Conclusions: The maturity of MDC reflected focused work of the Quality of Care sub-committee of the NCCCP. The efforts of working groups in patient navigation, genetics and physician conditions of participation was made evident in the improved performance in MDC’s for three of the four most common malignancies seen in the United States. We hope that this work will provide a blueprint for other health systems that wish to incorporate multidisciplinary care into their cancer programs. [Table: see text]

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

2012 ◽  
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 review contains 1 highly rendered figure, 3 tables, and 56 references.

A Learning Outcome Inspired Survey Instrument for Assessing the Quality of Continuous Improvement Cycle

2021 ◽  
pp. 702-724
Author(s):  
Abdallah Namoun ◽  
Ahmad Taleb ◽  
Mohammed Al-Shargabi ◽  
Mohamed Benaida
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Delphi Study ◽  
Assessment Tool ◽  
Survey Instrument ◽  
Assessment Instrument ◽  
Self Assessment ◽  
Continuous Quality ◽  
System Requirements

Measuring the effectiveness of a continuous quality improvement cycle in education is a cumbersome and sophisticated process. This article contributes a comprehensive self-assessment instrument for identifying the strengths and weaknesses of all phases of a continuous quality improvement cycle, including planning, data collection, analysis and reporting, and implementation of improvements. To this end, a four round Delphi study soliciting a total of 23 program quality experts from four universities was conducted. The produced survey instrument contains a total of 50 questions. The instrument may be used by quality experts in education to judge the quality of their continuous quality improvement cycle that endeavours to assess the attainment of learning outcomes in various undergraduate educational programs. Moreover, the instrument could be exploited to infer relevant user and system requirements and guide the development of an automated self-assessment tool aimed at identifying the shortcomings in educational continuous quality improvement cycles.

A Physician Self-Assessment Tool for Quality Improvement

2007 ◽  
Vol 29 (2) ◽  
pp. 38-43 ◽  
Author(s):  
Linda S. Kahn ◽  
Chester H. Fox ◽  
Diane E. Berdine ◽  
Julia Krause-Kelly ◽  
Vijayalakshmi Raghu
Keyword(s):  
Quality Improvement ◽  
Assessment Tool ◽  
Self Assessment

scholarly journals The Health Insurance Portability & Accountability Act and the Practice of Dentistry in the United States: System Security

2004 ◽  
Vol 5 (3) ◽  
pp. 158-167 ◽  
Author(s):  
Joseph E. Chasteen ◽  
Gretchen Murphy ◽  
Arden Forrey ◽  
David Heid
Keyword(s):  
United States ◽  
Health Insurance ◽  
Health Information ◽  
Assessment Tool ◽  
System Security ◽  
The United States ◽  
Daily Basis ◽  
Self Assessment ◽  
Security Rule ◽  
Health Insurance Portability

Abstract This article reviews the issues related to the Health Insurance Portability & Accountability Act (HIPAA) security rule that apply to dental practice. The security rule specifically addresses individually identifiable health information that is transmitted or maintained in electronic media. System security must be applied to the entire technical infrastructure for the practice environment as well as to the work culture on a daily basis and must be thought of as an enterprise asset. Security refers to all of the policies, procedures, tools, and techniques used to assure that privacy and confidentiality are adequately addressed in a healthcare system. HIPAA requires all covered entities that transmit or maintain electronic health information perform, and document, a risk assessment for security and develop a security plan to address major areas of concern. A self-assessment tool is provided in this article. Citation Chasteen JE, Murphy G, Forrey A, Heid D. The Health Insurance Portability & Accountability Act and the Practice of Dentistry in the United States: System Security. J Contemp Dent Pract 2004 August;(5)3:158-167.

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