scholarly journals Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada

2016 ◽  
Vol 43 (3) ◽  
pp. 530-540 ◽  
Author(s):  
Claire E.H. Barber ◽  
Deborah A. Marshall ◽  
Dianne P. Mosher ◽  
Pooneh Akhavan ◽  
Lori Tucker ◽  
...  
Keyword(s):  
Performance Measures ◽  
Inflammatory Arthritis ◽  
Waiting Times ◽  
Models Of Care ◽  
System Level ◽  
Allied Health Professionals ◽  
Modified Delphi ◽  
Timely Access ◽  
Care Systems ◽  
Level Performance

Objective.To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis.Methods.This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set.Results.Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita.Conclusion.The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.

scholarly journals A Transportation Performance Measurement System with a Mississippi Case Study

2010 ◽  
Author(s):  
Haiyuan Wang ◽  
Mingzhou Jin
Keyword(s):  
Performance Measures ◽  
Transportation Systems ◽  
System Level ◽  
Performance Measurement System ◽  
Intermodal Transportation ◽  
Design Alternatives ◽  
Level Performance ◽  
Existing Data ◽  
Highway System

In current literature and practices, there are no systematic and user-oriented intermodal transportation performance measures. After identifying customer needs and transportation goals, this paper proposes a set of system-level performance measures for intermodal transportation that are user-oriented, scalable, systematic, and scientific. The measures can be used to compare intermodal design alternatives or to evaluate existing transportation systems with any size and any mode. The highway system in Mississippi is analyzed as a case study. The case study demonstrates the existing data sources, the methods of calculating the measures, and the means of evaluating transportation systems with the measures.

System Level Performance Measures of Recovery

2003 ◽  
Author(s):  
Steven Onken ◽  
Jeanne Dumont ◽  
Priscilla Ridgeway ◽  
Doug Dornan ◽  
Ruth Ralph
Keyword(s):  
Performance Measures ◽  
System Level ◽  
Level Performance

A population‐based approach to reporting system‐level performance measures for rheumatoid arthritis care

2020 ◽  
Author(s):  
Claire E.H. Barber ◽  
Deborah A. Marshall ◽  
Elena Szefer ◽  
Cheryl Barnabe ◽  
Natalie J. Shiff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Performance Measures ◽  
Reporting System ◽  
Population Based ◽  
System Level ◽  
Level Performance

scholarly journals On-the-fly scheduling versus reservation-based scheduling for unpredictable workflows

2019 ◽  
Vol 33 (6) ◽  
pp. 1140-1158 ◽  
Author(s):  
Ana Gainaru ◽  
Hongyang Sun ◽  
Guillaume Aupy ◽  
Yuankai Huo ◽  
Bennett A Landman ◽  
...  
Keyword(s):  
Performance Measures ◽  
Data Centers ◽  
Large Data ◽  
Large Data Sets ◽  
System Level ◽  
Data Sets ◽  
Data Set ◽  
System Utilization ◽  
Average Stretch ◽  
Level Performance

Scientific insights in the coming decade will clearly depend on the effective processing of large data sets generated by dynamic heterogeneous applications typical of workflows in large data centers or of emerging fields like neuroscience. In this article, we show how these big data workflows have a unique set of characteristics that pose challenges for leveraging HPC methodologies, particularly in scheduling. Our findings indicate that execution times for these workflows are highly unpredictable and are not correlated with the size of the data set involved or the precise functions used in the analysis. We characterize this inherent variability and sketch the need for new scheduling approaches by quantifying significant gaps in achievable performance. Through simulations, we show how on-the-fly scheduling approaches can deliver benefits in both system-level and user-level performance measures. On average, we find improvements of up to 35% in system utilization and up to 45% in average stretch of the applications, illustrating the potential of increasing performance through new scheduling approaches.

Evaluating quality of care for rheumatoid arthritis for the population of Alberta using system-level performance measures

2020 ◽  
pp. jrheum.200420
Author(s):  
Claire E. H. Barber ◽  
Diane Lacaille ◽  
Peter Faris ◽  
Dianne Mosher ◽  
Steven Katz ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Performance Measures ◽  
Case Definition ◽  
National Standards ◽  
System Level ◽  
Standards Of Care ◽  
One Year ◽  
Incident Cases ◽  
Level Performance

Objective We evaluated 4 national rheumatoid arthritis (RA) system-level performance measures (PMs) in Alberta, Canada. Methods Incident and prevalent RA cases ≥ 16 years of age since 2002 were identified using a validated case definition applied in provincial administrative data. Performance was ascertained through analysis of health data between fiscal years 2012/13-2015/16. Measures evaluated were: proportion of incident RA cases with a rheumatologist visit within one year of first RA diagnosis code (PM1); proportion of prevalent RA patients dispensed a disease modifying anti-rheumatic drug (DMARD) annually (PM2); time from first visit with an RA code to DMARD dispensation, and proportion of incident cases where the 14-day benchmark for dispensation was met (PM3); and proportion of patients seen in annual follow-up (PM4). Results There were 31566 prevalent and 2730 incident RA cases (2012/13). Over the analysis period, the proportion of patients seen by a rheumatologist within 1 year of onset (PM1) increased from 55 to 63%; however, the proportion of RA patients dispensed DMARDs annually (PM2) remained low at 43%. While the median time to DMARD from first visit date in people who received DMARDs improved over time from 39 to 28 days, only 38-41% of patients received treatment within the 14-day benchmark (PM3). The percentage of patients seen in yearly follow-up (PM4) varied between 73-80%. Conclusion The existing Alberta health care system for RA is suboptimal, indicating barriers to accessing specialty care and treatment. The results inform quality improvement initiatives required within the province to meet national standards of care.

System-level Performance Measures

2012 ◽  
pp. 299-300
Author(s):  
John A. Booth ◽  
Mitchell A. Seligson
Keyword(s):  
Performance Measures ◽  
System Level ◽  
Level Performance

scholarly journals High Adherence to System-Level Performance Measures for Rheumatoid Arthritis in a National Early Arthritis Cohort Over Eight Years

2018 ◽  
Vol 70 (6) ◽  
pp. 842-850 ◽  
Author(s):  
Claire E. H. Barber ◽  
Orit Schieir ◽  
Diane Lacaille ◽  
Deborah A. Marshall ◽  
Cheryl Barnabe ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Performance Measures ◽  
Early Arthritis ◽  
System Level ◽  
High Adherence ◽  
Level Performance

scholarly journals The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dimuthu Rathnayake ◽  
Mike Clarke
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Elective Surgery ◽  
Waiting Times ◽  
Surgical Care ◽  
High Income ◽  
Surgical Patients ◽  
Timely Access ◽  
Referral Systems

Abstract Background Long waiting times for elective surgery are common to many publicly funded health systems. Inefficiencies in referral systems in high-income countries are more pronounced than lower and middle-income countries. Primary care practitioners play a major role in determining which patients are referred to surgeon and might represent an opportunity to improve this situation. With conventional methods of referrals, surgery clinics are often overcrowded with non-surgical referrals and surgical patients experience longer waiting times as a consequence. Improving the quality of referral communications should lead to more timely access and better cost-effectiveness for elective surgical care. This review summarises the research evidence for effective interventions within the scope of primary-care referral methods in the surgical care pathway that might shorten waiting time for elective surgeries. Methods We searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases in December-2019 to January-2020, for articles published after 2013. Eligibility criteria included major elective surgery lists of adult patients, excluding cancer related surgeries. Both randomised and non-randomised controlled studies were eligible. The quality of evidence was assessed using ROBINS-I, AMSTAR 2 and CASP, as appropriate to the study method used. The review presentation was limited to a narrative synthesis because of heterogeneity. The PROSPERO registration number is CRD42019158455. Results The electronic search yielded 7543 records. Finally, nine articles were considered as eligible after deduplication and full article screening. The eligible research varied widely in design, scope, reported outcomes and overall quality, with one randomised trial, two quasi-experimental studies, two longitudinal follow up studies, three systematic reviews and one observational study. All the six original articles were based on referral methods in high-income countries. The included research showed that patient triage and prioritisation at the referral stage improved timely access and increased the number of consultations of surgical patients in clinics. Conclusions The available studies included a variety of interventions and were of medium to high quality researches. Managing patient referrals with proper triaging and prioritisation using structured referral formats is likely to be effective in health systems to shorten the waiting times for elective surgeries, specifically in high-income countries.

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