Alliance will evaluate clinical excellence

Intent is to provide organizationwide, measurable goals for hospitals. All 5,000 hospitals in the United States are being rated on clinical outcomes. Evaluations will examine 20 procedures in six different specialty areas.     

A framework for developing excellence as a clinical educator

The current emphasis on providing quality undergraduate and postgraduate medical education has focused attention on the educational responsibilities of all doctors. There is a greater awareness of the need to train doctors as educators and courses have been set up to satisfy this need. Some courses, such as those on how to conduct appraisal, are specific to one task facing a medical educator. Other courses take a broader view and relate educational theory to practice. In this paper we describe an outcome-based approach in which competence in teaching is defined in terms of 12 learning outcomes. The framework provides a holistic approach to the roles of the teacher and supports the professionalism of teaching. Such a framework provides the basis for the development of a curriculum for teaching excellence. It helps to define important competences for different categories of teachers, communicate the areas to be addressed in a course, identify gaps in course provision, evaluate courses, assist in staff planning and allow individuals to assess their personal learning needs. The framework is presented to encourage wider debate.     

Centres of excellence

The present Government may not be enthusiastic about health centres. But Dr Joyce M. Watson, of Glasgow University Department of General Practice and based at Woodside Health Centre in Glasgow, writes with enthusiasm of their advantages for the practice of medicine and the care of patients.     

Training centre of excellence

At Hensol Hospital in Mid Glamorgan a commercial conference centre has been set up to train staff in mental handicap services. As Alison Hyde reports, the centre's successes have not been just financial ones.     

Changing clinical practice by improving systems: the pursuit of clinical excellence through practice-based measurement for learning and improvement

Physicians often wait for a health plan, a health maintenance organization (HMO), or an integrated health care system to bring about change or improvement in health care. But small changes in systems--the patient self care system, an individual practice, or a group practice (microsystem)--can have a profound impact on outcomes in an organization (macrosystem). With simple graphical tools, physicians and patients can be taught to measure and be empowered to improve both health and health care. Using these tools and a well-known and widely accepted method for clinical improvement called rapid cycle testing, a population of patients with diabetes improved average fasting blood sugar (FBS) from 187 to 110 and the average hemoglobin A1c (HbA1c) from 10.5 to 7.2.     

Using the business excellence model to effectively manage change within clinical support services.

This article describes the journey of managing the change from seven separate health providing units to one overall team providing a range of services. To facilitate the change the Malcolm Baldrige National Quality Award self-assessment model was used. The benefits and limitations of the model are described as are the activities undertaken to achieve a goal of delivering quality care within a customer driven rather than service driven focus. Finally the learning gained from the change is shared in an attempt to help others undertaking a similar journey.     

A call to excellence

Health care improvement affects us all and is not optional. For change to occur, consumers must demand excellence from their providers and clinicians. Patient safety is part of a broader set of health care quality issues. Championing this view will not be easy, for it means fundamental change to the myriad interrelated systems that make up U.S. health care. HHS is taking the lead on patient safety through a number of initiatives and activities.