Using Technology to Support Data Analytics: A Chief Nursing Officer Accountability Scorecard.

Accountability for health system improvement is a requirement for nursing leadership in practice. However, to be accountable for organizational goals, nurse leaders need the tools to identify gaps in their microsystems of care. The purpose of this article was to provide a case study example of chief nursing officer (CNO) leadership in using a technology solution to develop a CNO accountability scorecard. This project highlights the HQ Essential for data analytics using an innovative technological approach to drive improvement at the front line of clinical care.

St. Michael's Improvement Program - A Collaborative Approach to Sustainable Cost Savings.

In response to a challenging financial environment and increasing patient demand, St. Michael's Hospital needed to find long-term sustainable solutions to continue to provide high-quality patient care and invest in key priorities. By conducting Operational Reviews in focused areas, the hospital achieved $7.4 million of in-year savings in the first year, found standardizations, process efficiencies and direct cost savings that positioned itself for success in future funding models. Initiatives were grounded in evidence and relied heavily on the effective execution by the leadership, front-line staff and physicians. As organizations face similar challenges, this journey can provide key learnings.

A New Approach of Measuring Hospital Performance for Low- and Middle-income Countries.

Efficiency of the hospitals affects the price of health services. Health care payments have equity implications. Evidence on hospital performance can support to design the policy; however, the recent literature on hospital efficiency produced conflicting results. Consequently, policy decisions are uncertain. Even the most of evidence were produced by using data from high income countries. Conflicting results were produced particularly due to differences in methods of measuring performance. Recently a management approach has been developed to measure the hospital performance. This approach to measure the hospital performance is very useful from policy perspective to improve health system from cost-effective way in low and middle income countries. Measuring hospital performance through management approach has some basic characteristics such as scoring management practices through double blind survey, measuring hospital outputs using various indicators, estimating the relationship between management practices and outputs of the hospitals. This approach has been successfully applied to developed countries; however, some revisions are required without violating the fundamental principle of this approach to replicate in low- and middle-income countries. The process has been clearly defined and applied to Nepal. As the results of this, the approach produced expected results. The paper contributes to improve the approach to measure hospital performance.

The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department.

QUALITY PROBLEM OR ISSUE: Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data. INITIAL ASSESSMENT: The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks. CHOICE OF SOLUTION: Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks. IMPLEMENTATION: The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines. EVALUATION: The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management. LESSONS LEARNED: The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings.

Healthcare BI: a tool for meaningful analysis.

Implementing an effective business intelligence (BI) system requires organizationwide preparation and education to allow for meaningful analysis of information. Hospital executives should take steps to ensure that: Staff entering data are proficient in how the data are to be used for decision making, and integration is based on clean data from primary sources of entry. Managers have the business acumen required for effective data analysis. Decision makers understand how multidimensional BI offers new ways of analysis that represent significant improvements over historical approaches using static reporting.

Proposta de instrumento de registro de dados para monitorar os resultados das auditorias de gestão / Proposal for data recording instrument to monitor the results of performance audits

O objetivo da pesquisa foi a elaboração de um instrumento de coleta de dados que permita agregar e consolidar informações sobre falhas presentes na administração pública e com isso possibilitar o monitoramento e a avaliação da adequação das estruturas de controles internos de uma organização. O instrumento, baseado em metodologia formulada para esse objetivo, pretende capturar vários aspectos relativos aos controles internos das organizações auditadas, com base na legislação e nos exames eavaliações previstas nos procedimentos de auditoria.

Billing: the lifeblood of your business--does yours measure up? A roadmap to assess your billing performance and audit your billing practices.

Billing represents one of the most critical aspects of a medical practice, impacting your revenue, cash flow, and overall financial results. Yet many physicians do not have a clear understanding of their billing performance and, more importantly, how it affects the bottom line. This article examines key areas of medical billing, including steps to analyze your practice's performance against industry benchmarks. It also includes a real-world case study that highlights one practice's billing performance and opportunity for improvement.

Experiences of using the GMP audit preparation tool in pharmaceutical contract manufacturer audits.

BACKGROUND: Use of external contractors is nowadays inevitable in the pharmaceutical industry. Therefore the amount of current good manufacturing practice audits has been increasing. During the audit, a large amount of items should be covered in a limited amount of time. Consequently, pharmaceutical companies should have systematic and effective ways to manage and prepare for the audits. This study is a continuation to the earlier study, where a tool for the preparation of cGMP audit was developed and its content was validated. The objective of this study was to evaluate the usefulness of the developed tool in audit preparation and during the actual cGMP audit. METHOD: Three qualitative research methods were used in this study (observation, interviews, and opinion survey). First, the validity of the information given through the tool was examined by comparing the responses to the actual conditions observed during the contract manufacturer audits (n = 15). Additionally the opinions of the contract manufacturers of the tool were gathered (n = 10) and the auditors were interviewed (n = 2). RESULTS: The developed tool was proven to be useful in audit preparation phase from both the auditor's and the contract manufacturers' point of view. Furthermore, using the tool can also save some time when performing the audit. CONCLUSION: The results show that using the tool can give significant support in audit preparation phase and also during the actual audit.

Measuring the built environment for physical activity: state of the science.

Physical inactivity is one of the most important public health issues in the U.S. and internationally. Increasingly, links are being identified between various elements of the physical-or built-environment and physical activity. To understand the impact of the built environment on physical activity, the development of high-quality measures is essential. Three categories of built environment data are being used: (1) perceived measures obtained by telephone interview or self-administered questionnaires; (2) observational measures obtained using systematic observational methods (audits); and (3) archival data sets that are often layered and analyzed with GIS. This review provides a critical assessment of these three types of built-environment measures relevant to the study of physical activity. Among perceived measures, 19 questionnaires were reviewed, ranging in length from 7 to 68 questions. Twenty audit tools were reviewed that cover community environments (i.e., neighborhoods, cities), parks, and trails. For GIS-derived measures, more than 50 studies were reviewed. A large degree of variability was found in the operationalization of common GIS measures, which include population density, land-use mix, access to recreational facilities, and street pattern. This first comprehensive examination of built-environment measures demonstrates considerable progress over the past decade, showing diverse environmental variables available that use multiple modes of assessment. Most can be considered first-generation measures, so further development is needed. In particular, further research is needed to improve the technical quality of measures, understand the relevance to various population groups, and understand the utility of measures for science and public health.

Speculating to accumulate: reducing the cost of wound care by appropriate dressing selection.

The key determinants of wound-care costs are well known. When undertaking local audits, practitioners are advised to collect data against each of these determinants and then use them to formulate cost-effective dressing formularies.

Data envelopment analysis comparison of hospital efficiency and quality.

Using a sample of Virginia hospitals, performance measures of quality were examined as they related to technical efficiency. Efficiency scores for the study hospitals were computed using Data Envelopment Analysis (DEA). The study found that the technically efficient hospitals were performing well as far as quality measures were concerned. Some of the technically inefficient hospitals were also performing well with respect to quality. DEA can be used to benchmark both dimensions of hospital performance: technical efficiency and quality. The results have policy implications in view of growing concern that hospitals may be improving their efficiency at the expense of quality.

Auditoria e controladoria / Curso de Aperfeiçoamento em Gestão Estratégica por Resultados em Saúde a Distância

CD-ROM contém vídeo de apresentação do em formato de vídeo juntamente com vídeos aulas da disciplina auditoria e controladoria do curso de gestão estratégica por resultados em saúde a distância. Contém o livro do curso e orientações aos estudantes em formato PDF e aplicativo da disciplina. Objetiva apresentar as potencialidades, virtualidades e debilidades dos orçamentos, os processos de elaboração de orçamentos, controle operacional e aspectos comportamentais da gestão orçamentária

Comparison of administrative-only versus administrative plus chart review data for reporting HEDIS hybrid measures.

OBJECTIVE: Health plans, medical groups, and commercial vendors are using administrative data to measure clinical performance at the plan or physician level. We compared results of using administrative claims data alone versus administrative data combined with chart review for selected Healthcare Effectiveness Data and Information Set (HEDIS) measures. STUDY DESIGN: Cross-sectional comparison of health plan performance rates using different methods of data collection. METHODS: We analyzed data reported by 283 commercial managed care plans in 2004 and 2006 for 15 HEDIS hybrid measures. Hybrid specifications included the use of administrative data supplemented with medical record review and required plans to report performance rates based on administrative data only and for administrative data supplemented with chart review. We calculated differences in rates and changes in quartile rankings of health plans between the 2 reported rates. RESULTS: Performance rates using administrative data alone were substantially lower than rates using combined data (average difference of 20.4 percentage points). On average, more than half of the plans had different quartile rankings based on administrative-only rates versus combined data rates. Measures relying on laboratory claims or laboratory results had the largest discrepancies. CONCLUSIONS: Currently available health plan administrative data alone do not appear to provide sufficiently complete results for ranking health plans on HEDIS quality-of-care measures with hybrid specifications. The results suggest that reporting of clinical performance measures using administrative data alone should include prior testing and reporting on the completeness of data, relative rates, and changes in rankings compared with the use of combined administrative data and chart review.