Sujet(s)
Tumeur du sein de l'homme/diagnostic , Tumeur du sein de l'homme/thérapie , Tumeurs du sein/diagnostic , Tumeurs du sein/thérapie , Tumeurs du sein/anatomopathologie , Tumeur du sein de l'homme/anatomopathologie , Femelle , Humains , Mâle , Études observationnelles comme sujet , Essais contrôlés randomisés comme sujetSujet(s)
Tumeurs du sein/anatomopathologie , Tumeurs du sein/thérapie , Soins palliatifs , Récepteur ErbB-2/analyse , Récepteurs des oestrogènes/analyse , Antinéoplasiques/usage thérapeutique , Tumeurs du sein/composition chimique , Conférences de consensus comme sujet , Femelle , Humains , Tumeurs du sein triple-négatives/traitement médicamenteuxRÉSUMÉ
INTRODUCTION: Measuring and improving quality of care is of primary interest to patients, clinicians, and payers. The National Consortium of Breast Centers (NCBC) has created a unique program to assess and compare the quality of interdisciplinary breast care provided by breast centers across the country. METHODS: In 2005 the NCBC Quality Initiative Committee formulated their initial series of 37 measurements of breast center quality, eventually called the National Quality Measures for Breast Centers (NQMBC). Measures were derived from published literature as well as expert opinion. An interactive website was created to enter measurement data from individual breast centers and to provide customized comparison reports. Breast centers submit information using data they collect over a single month on consecutive patients. Centers can compare their results with centers of similar size and demographic or compare themselves to all centers who supplied answers for individual measures. New data may be submitted twice yearly. Serially submitted data allow centers to compare themselves over time. NQMBC random audits confirm accuracy of submitted data. Early results on several initial measures are reported here. RESULTS: Over 200 centers are currently submitting data to the NQMBC via the Internet without charge. These measures provide insight regarding timeliness of care provided by radiologists, surgeons, and pathologists. Results are expressed as the mean average, as well as 25th, 50th, and 75th percentiles for each metric. This sample of seven measures includes data from over 30,000 patients since 2005, representing a powerful database. In addition, comparison results are available every 6 months, recognizing that benchmarks may change over time. CONCLUSIONS: A real-time web-based quality improvement program facilitates breast center input, providing immediate comparisons with other centers and results serially over time. Data may be used by centers to recognize high-quality care they provide or to identify areas for quality improvement. Initial results demonstrate the power and potential of web-based tools for data collection and analysis from hundreds of centers who care for thousands of patients.
Sujet(s)
Tumeurs du sein/diagnostic , Tumeurs du sein/thérapie , Établissements de cancérologie/normes , Assurance de la qualité des soins de santé/organisation et administration , Qualité des soins de santé , Bases de données factuelles , Femelle , Adhésion aux directives , Humains , , Évaluation de programmeRÉSUMÉ
This article describes the organizational structure and functions of the quality assurance/utilization management (QA/UM) department at The Johns Hopkins Hospital (Baltimore), which has developed a proactive QA/UM program for identifying opportunities to control inappropriate inpatient admissions, shorten a patient's length of stay, monitor the use of ancillary services, and improve physician documentation in patient medical records. In addition, the QA/UM department has developed and implemented an aggressive third-party appeal mechanism to ensure that the institution has an effective UM program. The QA/UM department annually recovers more than 3 million dollars for the hospital by aggressively appealing third-party payer denials. Specific chart-review variables are outlined.