RESUMO
Realizing the importance of linking nursing's contribution to quality patient care, a pilot study was conducted to determine whether data regarding the quality indicators proposed by the American Nurses' Association (ANA) could be collected from five acute-care inpatient units at one medical center that is part of a multisite managed care system. Although it was determined that data regarding the ANA quality indicators could be collected at the study site, a variety of unanticipated findings emerged. These findings reflect both discrepancies and congruities between how the investigative team expected the ANA indicators to operate versus what was actually experienced. The lessons learned while collecting ANA indicator data are shared to assist future users and to advance the evolution of the ANA indicators.
Assuntos
American Nurses' Association , Coleta de Dados/métodos , Pesquisa em Administração de Enfermagem/métodos , Cuidados de Enfermagem/normas , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Infecção Hospitalar/prevenção & controle , Coleta de Dados/normas , Humanos , Tempo de Internação , Programas de Assistência Gerenciada/normas , Pesquisa em Administração de Enfermagem/normas , Recursos Humanos de Enfermagem Hospitalar/provisão & distribuição , Avaliação de Processos e Resultados em Cuidados de Saúde/organização & administração , Satisfação do Paciente , Projetos Piloto , Carga de TrabalhoRESUMO
PURPOSE: To provide a framework for classifying outcome indicators for a more comprehensive view of outcomes and quality. METHODS: Review of outcomes literature published since 1974 from medicine, nursing, and health services research to identify indicators. Outcome indicators were clustered inductively. FINDINGS: Three groups of outcome indicators were identified: patient-focused, provider-focused, and organization-focused. Although investigators tend to focus on a select few outcome indicators, such as patient satisfaction, quality of life, and mortality, many indicators exist to measure outcomes. CONCLUSIONS: Selecting and integrating a wide array of outcome indicators from the various categories will provide a more balanced view of health care delivery as compared with focusing on a few common indicators or only one category.
Assuntos
Avaliação de Resultados em Cuidados de Saúde/classificação , Indicadores de Qualidade em Assistência à Saúde/classificação , Grupos Diagnósticos Relacionados/classificação , Eficiência Organizacional , Saúde Holística , Humanos , Mortalidade , Objetivos Organizacionais , Satisfação do Paciente , Assistência Centrada no Paciente/organização & administração , Qualidade de Vida , Reprodutibilidade dos TestesRESUMO
Clinical case management is a system that has the potential to improve the efficiency and effectiveness of health care delivery. Given this potential, the Army Medical Department (AMEDD) is examining this process as a means to achieve goals of quality care and cost effectiveness. In this article, the authors describe the concept of case management, the AMEDD system of clinical case management, the implementation of clinical case management in the AMEDD, and the role of the case manager.