The standing operational implementation team--playing a vital role in successful project completion, implementation of operational initiatives, and process improvement

The most detailed and well-documented project plan or process improvement initiative will certainly fall short of expectations if the appropriate team is not assembled to execute it. A standing operational implementation team, representing all major stakeholders in the organization, takes the guesswork out of who to engage and when. Applying this concept, as well as some basic project management concepts, can be used to help guide facilitators who are not project management professionals toward successful project completion or process improvement initiatives.     

Business coalition initiatives related to behavioral healthcare purchasing and quality improvement

Across America there are over 90 employer health coalitions, and their ranks are growing. Their members can be businesses located in a city, a region or a state, while a few encompass employers located in multistate regions. Coalitions may include only private-sector employers, or private- and public-sector employers; some are coalitions between employer purchasers and providers. Following a brief historical overview, this article summarizes the behavioral healthcare initiatives that are currently under way in six business coalitions.     

The role of accreditation in quality oversight and improvement under healthcare reform

Quality measurement and management are key components of the administration's healthcare reform proposal, and translating outcomes information into "report cards" for healthcare consumers and purchasers will create a "final common pathway to public accountability," according to Dennis S. O'Leary, MD, and Paul M. Schyve, MD, senior spokesmen for the Joint Commission on Accreditation for Healthcare Organizations. While the nature of the accreditation process as it currently exists may well change, the authors insist that the measurement and monitoring process that is ultimately adopted must include both performance standards and outcomes measures.     

The Armenian healthcare system: recent changes and challenges

Background  Armenian healthcare reforms have been carried out since independence in 1991, but achieved their full scale starting in 1995–1996. Although the healthcare system has already been modified and changed for 10 years, there is a lack of research in this regard. Objectives  This paper aims to present the organization of the healthcare system in Armenia, its changes and challenges throughout the reform process. Methods  This paper is mainly based on a review of the relevant professional literature, a review and interpretation of legal acts in the healthcare field, and a review of research and assessment works done by several international and local organizations. Results  There are still large numbers of elements typical for the Soviet Semashko model in Armenian healthcare structures. Implemented reforms have separated the institutions of the public payer and the providers, but did not manage to change the model of financing to be based on compulsory insurance. The level of financing is similar to the average in Central and Eastern Europe, but is based mainly on out-of-pocket payments contributing to about 80% of all system resources. The informal payments reach even 45% of expenditures. The structure of hospital beds remains ineffective, and there are still no mechanisms of increasing the quality of services. Privatization has been applied, but the role of private providers is still limited. Conclusions  The reforms have not caused satisfactory improvement in healthcare performance, although the health indicators are better than at the beginning of the transformation period. The stability of the reforming processes in previous years as well as the engagement of international institutions is a chance for positive changes in the near future.     

The process of managerial control in quality improvement initiatives

The fundamental intent of strategic management is to position an organization with in its market to exploit organizational competencies and strengths to gain competitive advantage. Competitive advantage may be achieved through such strategies as low cost, high quality, or unique services or products. For health care organizations accredited by the Joint Commission on Accreditation of Healthcare Organizations, continually improving both processes and outcomes of organizational performance--quality improvement--in all operational areas of the organization is a mandated strategy. Defining and measuring quality and controlling the quality improvement strategy remain problematic. The article discusses the nature and processes of managerial control, some potential measures of quality, and related information needs.     

Nursing home quality indicators and quality improvement initiatives

Quality indicators and a quality monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. The approach is particularly useful in routine and special quality assurance efforts.     

基于质量功能展开技术的某社区医疗服务质量改进研究

目的 应用质量功能展开(QFD)技术定量识别服务改进优先级,从而有针对性地提出改进医疗服务质量措施,为相关社区医疗服务质量改进提供方法学的参考.方法 在调查社区患者需求的基础上,通过层次分析法(AHP)确定患者需求的重要度,应用质量功能展开中的质量屋(HOQ)技术,将患者的需求转化成相应的医疗服务质量保障要素,通过计算最终确定各保障要素改进的优先级.结果 强化医务人员服务管理与考核、提升医务人员业务素质、实施医务人员道德考评、开展疾病预防及康复和健康咨询与培训等,分列优先改进的前4位,优先级分值分别为174.9、156.8、116.9和98.9.结论 通过对某社区卫生服务中心的案例研究,表明质量功能展开技术可为改进社区医疗服务质量提供有效的方法学参考.     

The role of healthcare work environments in shaping a safety culture

Patient safety is a basic goal of all Canadian healthcare organizations. Yet we still have much to learn about the determinants of safety. For instance, little is known about the how workplace environment factors that have an influence on employee behaviour also have implications for patient safety.     

Award winner involves entire staff in quality improvement initiatives

Have non-clinical departments identify activities that can contribute to improved outcomes. Create standing interdisciplinary teams to continually monitor best practices. Engender transparency and excellence with individualized scorecards for your staff and leaders.     

The challenges of implementing quality improvement in small rural hospitals

In the five years since launching its QI initiative, Mason General Hospital has dealt with many of the challenges that commonly arise in healthcare organizations during TQM implementation, including involving physicians and training staff. It also had to address a host of issues common to small rural organizations. At first glance, one might suspect that the move toward QI would be easier in a small organization because there are fewer leaders to orient, fewer people involved in work processes, and fewer levels of management. In fact, the small organization presents special challenges, including limited staff and financial resources, high turnover rates in key medical staff leadership positions, and small sample sizes. The strategies used by Mason General Hospital to respond to these and other challenges provide a model for small rural healthcare organizations.     

The role of the Internet in improving healthcare quality

The Internet is a tool that has the potential to greatly affect and improve the quality of healthcare. This article discusses the ways in which the Internet is being utilized by healthcare administrators, physicians, and healthcare consumers to enhance the quality of care. Despite the Internet's growing popularity and use, several barriers remain that prevent its full implementation in the healthcare field. This article offers guidelines for administrators in using the Internet within their organizations.     

Using indicators to structure quality improvement initiatives in long-term care

Quality indicators and a quality-monitoring system developed for use in the regulatory survey process offer a quality improvement tool for nursing home staff. The systematic use of resident assessment data can aid in the identification of quality of care problems and the determination of the nature of those problems. This approach is particularly useful for continuous quality improvement efforts.     

Differential access to quality rural healthcare: professional and policy challenges

Using a national dataset, the influence of the community and individual provider characteristics on the availability of healthcare resources in rural areas was evaluated. Disparities continue to exist in the availability of providers including organizational types of providers such as Community Health Centers and Community Mental Health Centers. A lower percentage of nonmetropolitan counties have such centers, and more rural counties within the general grouping of nonmetropolitan counties have fewer of these organizational resources. A case study on the Southwestern region of Virginia is presented to highlight the impact on health outcomes and an innovative community response to the lack of availability of needed healthcare services.     

Connecting the dots: grounding quality improvement and cost cutting initiatives in strategic planning

Discuss cost management and performance improvement with any manager at an acute care hospital and you will hear several consistent themes: Quality improvement (QI) has not produced the anticipated results on a timely basis; Focused cost reduction efforts have at best provided short-term benefits; and The organization needs to be more nimble, more responsive to the marketplace. If your hospital is wrestling with these issues, take some comfort in knowing that you are not alone. In general, the same problems are being experienced by long-term care facilities, group practices, practice plans, and most other provider organizations. However, all is not doom and gloom. A common-sense, easy-to-understand solution to the cost control problem can be implemented if an organization is disciplined and can exercise patience and diligence in implementation. Business Process Redesign (BPR), a performance improvement strategy and tactic that has been successfully deployed throughout private industry, can solve the problem. If undertaken correctly, BPR links the best concepts and principles of quality improvement, operations analysis, and focused cost reduction with an organization's strategic planning efforts. BPR results in the establishment of cost management initiatives that are consistent with the organization's long term goals. This article takes a closer look at the merits of BPR in a changing healthcare environment.