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Biomedical subjects

Shoshanna Sofaer

Publications and source records attributed to Shoshanna Sofaer.

6 recordsLinked to original sources
PubMed2003

Aligning quality for populations and patients: do we know which way to go?

Both the medical care and public health systems have invested considerable resources to define, measure, and improve quality and health outcomes. A movement toward accountability has generated performance indicators from the medical arena and "leading health indicators" from the public health arena. The focus on specific conditions by the medical care system has been at odds with public health's emphasis on improving population health and has perpetuated a bifurcated system. Aligning the goals of medical care with those of public health will require reformulation of performance measurement and accountability into a common language that is valued by both systems. Such a creation would amount to a whole that is stronger than the sum of the component parts.

Cooperative Behavior↗
PubMed2002

Qualitative research methods.

The use of rigorous qualitative research methods can enhance the development of quality measures, the development and dissemination of comparative quality reports, as well as quality improvement efforts. This paper describes how such methods have been and can be used, and identifies how to improve the use of such methods in studying quality of care. Focus groups and cognitive interviews are now a standard part of the development of valid and reliable survey instruments. They are particularly useful in developing surveys to gather data on the experiences and responses of patients and consumers to plans, services, and providers. These two methods have also been adapted and applied to improve the development and dissemination of comparative quality reports to consumers and other audiences, while key informant interviews and focus groups have been critical in the exploratory assessment of stakeholder responses to reports and their effects on consumers. Interviews have also been used to identify best practices found in health plans receiving high scores on the Consumer Assessment of Health Plans Surveys and measures of effectiveness in the Health Employer Data and Information Set. It would be valuable to widen the use of qualitative methods, especially structured observations, to document in detail the delivery of services designed to improve quality, so the implementation of complex processes can be more carefully measured and related to outcomes. The design and conduct of rigorous qualitative research takes a skilled and experienced team. Issues commonly faced in quantitative work must also be addressed in qualitative studies, including study design, specification of the unit of analysis, sampling, instrument design and administration, and, in particular, data analysis. It is especially critical that the analysis and interpretation process be deliberate and thorough to avoid the use of initial impression rather than detailed examination of the raw data.

Consumer Behavior↗
PubMed2002

Evaluating partnerships for community health improvement: tracking the footprints.

Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership's ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations' perceived benefits and costs of participation and management capabilities to the partnership's progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.

Community Health Planning↗
PubMed2002

Public reporting of hospital patient satisfaction: the Rhode Island experience.

This article describes a collaborative process for legislatively mandated public reporting of health care performance in Rhode Island that began with hospital patient satisfaction. The goals of the report were both quality improvement and public accountability. Key features addressed include: the legislative context for public reporting; widespread participation of stakeholders; the structure for decision making; and the use of formative testing with cognitive interviews to get responses of consumers and others about the report readability and comprehensibility. This experience and the lessons learned can guide other States considering public reporting on health care performance.

Adolescent↗
PubMedDate not supplied

Consumers and quality-driven health care: a call to action.

A key strategy for driving improvements in health care quality is providing comparative quality information to consumers. This strategy will not work, and could even be counterproductive, unless (1) consumers are convinced that quality problems are real and consequential and that quality can be improved; (2) purchasers and policymakers make sure that quality reporting is standardized and universal; (3) consumers are given quality information that is relevant and easy to understand and use; (4) the dissemination of quality information is improved; and (5) purchasers reward quality improvements and providers create the information and organizational infrastructure to achieve them.

Benchmarking↗