Use of the Triple Aim to improve population health

CaroMont Health has embraced the Triple Aim initiative to implement its core vision and competencies of delivering health care, promoting individual wellness, and creating vibrant communities. An imperative to achieve success has been aligning the corporate goals with the processes and outcomes that foster the Triple Aim.     

城区社区卫生服务人才现状与对策

对静安寺街道社区卫生服务中心35岁以下的36名职工进行问卷调查。青年技术人才匮乏,人才队伍老化,尤其是35岁以下的公共卫生医师仅占总数的1／10;97％的青年人希望单位能提供更多的学习机会及更好的工作环境。因此只有通过建立健全工作制度、人才规划和分配机制,才能吸引人才、培养人才、留住人才,才能提高社区卫生人员素质,并达到促进社区卫生服务可持续发展的最终目的。     

提高县医院检验科医疗服务质量的几点体会

县医院是三级医院管理体系中间层次的综合性医院,其虽属于＂二级甲等＂医院,但相对于市级同级医院,又面临着人员明显不足、素质参差不齐、设备相对简陋、工作条件较差、患者素质偏低及经济状况较差、病程较长而且病情较重等现实。     

加强体检资料分析利用完善后续服务流程

总结了当前医院健康体检资料管理及利用中存在的问题与不足;分析了加强体检资料分析利用的积极作用和意义;提出了构建体检后服务流程的目标与方法。     

External incentives,information technology,and organized processes to improve health care quality for patients with chronic diseases

Context  Organized care management processes (CMPs) can improve health care quality for patients with chronic diseases. The Institute of Medicine of the National Academy of Sciences has called for public and private purchasers of health care to create incentives for physician organizations (POs) to use CMPs and for the government to assist POs in implementing information technology (IT) to facilitate CMP use. Research is lacking about the extent to which POs use CMPs or about the degree to which incentives, IT, or other factors are associated with their use. Objectives  To determine the extent to which POs with 20 or more physicians use CMPs and to identify key factors associated with CMP use for 4 chronic diseases (asthma, congestive heart failure, depression, and diabetes). Design, Setting, and Participants  One thousand five hundred eighty-seven US POs (medical groups and independent practice associations) with 20 or more physicians were identified using 5 large databases. One thousand one hundred four of these POs (70%) agreed to participate in a telephone survey conducted between September 2000 and September 2001. Sixty-four responding POs were excluded because they did not treat any of the 4 diseases, leaving 1040 POs. Main Outcome Measures  Extent of use of CMPs as calculated on the basis of a summary measure, a PO care management index (POCMI; range, 0-6) and factors associated with CMP use. Results  Physician organizations' mean use of CMPs was 5.1 of a possible 16; 50% used 4 or fewer. External incentives and clinical IT were most strongly associated with CMP use. Controlling for other factors, use of the 2 most strongly associated incentives—public recognition and better contracts for health care quality—was associated with use of 1.3 and 0.7 additional CMPs, respectively (P<.001 and P = .007). Each additional IT capability was associated with 0.37 additional CMPs (P<.001). However, 33% of POs reported no external incentives and 50% reported no clinical IT capability. Conclusions  The use of CMPs varies greatly among POs, but it is low on average. Government and private purchasers of health care may increase CMP use by providing external incentives for improvement of health care quality to POs and by assisting them in improving their clinical IT capability.      

Maximizing the benefits of health care information systems

Information systems can improve cost control, increase the timeliness and accuracy of patient care and administration information, increase service capacity, reduce personnel costs and inventory levels, and improve the quality of patient care. However, experience shows that most of these benefits will not occur automatically following system implementation. Operational problems may exist that diminish information timeliness, accessibility, and accuracy; policies and procedures may not have been sufficiently tailored to reflect the realities and intents of the systems; and personnel tasks may not have been adequately restructured. In order to realize the full potential of information systems, health care organizations must plan for and implement strategies that are designed to maximize such benefits. This paper describes a method for developing benefits maximization strategies. The processes used to define strategies and their outcomes are presented.     

Use of a computerised maternity information system to improve clinical effectiveness: thromboprophylaxis at caesarean section

An audit of the introduction of a protocol for thromboprophylaxis at caesarean section revealed over treatment of low risk women and the under treatment of high risk women. A routine computer generated risk assessment profile was introduced as part of a maternity information system. Reaudit showed a significant improvement in adherence to the thromboprophylaxis protocol in all risk groups.     

Veterans Affairs Research and Development: using science to improve health care for veterans

VA has a rich tradition in supporting research in areas that span basic science to health system implementation. Its unique success is tied to the fact that researchers are focused on issues that arise from a unique population--our nation's veterans. Moreover, because VA is the largest integrated health system in the country and because the health system must manage an annual budget, there is a keen interest among VA health administrators to apply research that enhances quality and efficiency of care. Furthermore, because these findings overlap with the general population, VA Research & Development programs can be applicable on a much broader scale.     

Use of integrated care delivery to improve the quality of diabetes management among African Americans

The prevalence of type 2 diabetes is increasing, and racial disparities in that prevalence persist. Reimbursement policies do not match the innovative care delivery systems that have been developed. One key policy goal involves reimbursement for diabetes care delivered by physician and nonphysician health care professionals on the same day. Our evidence suggests that this integrated care improves outcomes among patients.