Biomedical subjects
M Morris
Publications and source records attributed to M Morris.
Relation of sociodemographic, clinical, and quality-of-life variables to adherence in the cardiac arrhythmia suppression trial.
Clearly, age and education are important factors for predicting adherence in CAST, given that they appear in all three regressions. Moreover, the 4-month and 1-year results indicate that mental health and presence of a spouse are important predictors. Physical function, stress, angina, and history of MI may also provide additional information regarding adherence levels. It is interesting to note that although adherence was higher for patients who have "good" social characteristics, such as having a spouse, support, integration, perceived good health, good mental health, low stress, and education, it was also better for those patients who had "poor" physical characteristics such as a history of angina, a history of MI, and low physical function. In the multivariate analysis, older age was also associated with good adherence. These observations are not necessarily intuitive and support the need for further research in this area. If patients at risk for poor adherence can be identified prospectively, strategies may be developed to improve their subsequent medical care in such a way to favorably affect and improve their outcomes.
Development of an outcomes management program at an academic medical center.
BACKGROUND: With the advent of managed care, academic medical centers have been challenged to lower costs and to document their claims of high quality outcomes. A successful method to achieve these objectives must not interfere with the academic missions of research and teaching. At M. D. Anderson Cancer Center, we initiated a program that would reduce practice variability and increase quality with a model that was familiar to the faculty. METHODS: Professional staff members were divided into disease site groups that included physicians, nurses, and other allied health staff. Each group developed practice guidelines and Collaborative Care Paths, based on evidence in the publications and on expert opinion. Desired outcomes were prospectively defined during this process. Before implementation, paths and guidelines underwent peer review. RESULTS: The faculty actively participated in the development and implementation of the program that was viewed as a means of empowerment to deal with managed care. Nearly 1000 patients have been entered on the B8 paths that have been implemented to date. CONCLUSION: A physician-driven outcomes management program permits delivery of high quality care and supports outcomes research while decreasing cost in an academic setting.