Variability in clinical systems: applying modern quality control methods to health care.
Jt Comm J Qual Improv
; 21(8): 407-19, 1995 Aug.
Article
en En
| MEDLINE
| ID: mdl-7496454
ABSTRACT
BACKGROUND:
Quality health care depends on timely completion of sequences of clinical care. This study evaluated the concepts and tools of quality management for measuring system performance in ambulatory care. STUDYDESIGN:
Clinical staff in nine centers of a group model health maintenance organization described the procedure for ordering and completing a complete blood count, mammogram, and surgical consultation. Variability was noted among the processes as intended and as actually performed, as well as inconsistencies reported within and among centers. In two centers investigators tracked performance of key sequences of care and the achievement of other key quality characteristics believed desired by physicians and patients. Computerized patient records and departmental files were the only available sources of data for assessing completion and followup of tests and consultations. Even these data were difficult to obtain and, in many instances, incomplete.RESULTS:
Although data were often difficult to obtain, the quality management techniques used were helpful in revealing process failures that appeared to be the result of design flaws built into the clinical systems.CONCLUSION:
Robust process designs and improved management information systems for monitoring these processes are recommended to reduce variability and improve the quality of clinical care.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Sistemas Prepagos de Salud
/
Evaluación de Procesos, Atención de Salud
/
Gestión de la Calidad Total
Tipo de estudio:
Prognostic_studies
Límite:
Female
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Jt Comm J Qual Improv
Asunto de la revista:
PESQUISA EM SERVICOS DE SAUDE
/
SERVICOS DE SAUDE
Año:
1995
Tipo del documento:
Article
País de afiliación:
Estados Unidos