Biomedical subjects
Publications and source records attributed to P L Spath.
The authors argue that accidental patient deaths are a significant public health concern and that public health professionals are well positioned to contribute to ongoing efforts to protect the public from unintended injuries in the hospital.
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With the immovable deadline of the new millennium close at hand, many medical facilities will find they are scrambling to be prepared. Neither sophisticated integrated health systems or small medical offices will go unaffected or untouched. It is important for risk managers to make it their priority to ensure that all aspects are being addressed.
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Early in the decade, health care discovered a powerful patient care management tool: the clinical path. Leaders in the field latched onto paths as the solution to cost and quality dilemmas, but they overlooked the importance of the underlying principles of quality management. Beyond Clinical Paths, a new book from American Hospital Publishing, focuses on the issues critical to successful quality improvement through clinical paths. The following excerpt by the book's editor, Patrice L. Spath, sets the stage for a new approach to clinical quality.
Clinical practice guidelines have introduced a new dimension to facility-level performance measurement--one which requires caregivers to change the way they have traditionally evaluated patient care practices. To successfully integrate guideline-derived evaluation tools into their performance measurement activities, practitioners and quality management professionals face new education and training challenges.
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Health care providers are being asked to collect, analyze, and evaluate the results of medical processes or procedures to improve the outcome of health care services. The linkage of process to outcome is not a new science, but it has assumed greater importance in today's health care economic climate. Medical effectiveness and outcomes management studies, once within the purview of health services investigators, are moving to the individual provider setting. This evolution has tremendous impact on health information management professionals. As the guardians of the data that are indispensable for medical effectiveness and outcomes management investigations, health information management professionals play a key role in caregivers' attempts to correlate process and outcome performance measures. The article discusses the historical origins of outcomes management, the prominence of outcomes management in health care reform activities, and the responsibilities of health information management professionals in these strategic initiatives.
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Hospital leadership, the Joint Commission, third-party payors, health care researchers, and others are repeatedly recognizing the essential role of information management in their quality improvement objectives. The health information department must become more proactive in its acknowledgment of these responsibilities by instituting the continuous quality improvement model. This model will prevent proactiveness from turning into mere reactiveness. As suggested by Peter Senge in The Fifth Discipline, "all too often, 'proactiveness' is reactiveness in disguise. If we simply become more aggressive fighting the 'enemy out there,' we are reacting--regardless of what we call it. True proactiveness comes from seeing how we contribute to our own problems."
It is unlikely the quality management program of the future will be able to effect quality improvements without sophisticated information management tools, one of which is the computer. While computerization is not required by the Joint Commission's Performance Assessment and Improvement Standard nor the Information Management Standard, both standards compel organizations to improve their information system capabilities. If the hospital quality management office attempts to survive without computerization, its ability to manipulate the many data elements required for measurement, assessment and improvement will be severely limited. Begin now to plan your computerization strategy.