Abstract
The quality movement in medicine is not a new idea, but it has become increasingly complex and nuanced. This chapter will review the basics of quality assessment and improvement in medicine, briefly discuss the various important programs, organizations and persons, explore data sources and metrics that inform quality decisions, and discuss how culture can influence outcomes and quality improvement. This chapter will focus on providing the basic information a young surgeon new to practice would find useful for understanding quality improvement and its impact on everyday health care.
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Quality: Dictionary.com. https://www.dictionary.com/browse/quality?s=t. Accessed 31 Aug 2018.
Safety: Dictionary.com. https://www.dictionary.com/browse/safety. Accessed 28 Oct 2018.
Donabedian A. An introduction to quality assurance in health care. New York: Oxford Univeristy Press; 2003.
Hoyt DB, Ko CY, editors. Optimal resources for surgical quality and safety. Chicago: American College of Surgeons; 2017.
Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000.
Institute of Medicine. Committee on Quality of Health Care in A. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy Press; 2001.
Kredo T, Bernhardsson S, Machingaidze S, Young T, Louw Q, Ochodo E, et al. Guide to clinical practice guidelines: the current state of play. Int J Qual Health Care. 2016;28(1):122–8.
Woolf SH, Grol R, Hutchinson A, Eccles M, Grimshaw J. Clinical guidelines: potential benefits, limitations, and harms of clinical guidelines. BMJ. 1999;318(7182):527–30.
Clay-Williams R, Colligan L. Back to basics: checklists in aviation and healthcare. BMJ Qual Saf. 2015;24(7):428–31.
Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491–9.
Reames BN, Krell RW, Campbell DA Jr, Dimick JB. A checklist-based intervention to improve surgical outcomes in Michigan: evaluation of the Keystone Surgery program. JAMA Surg. 2015;150(3):208–15.
Boyd J, Wu G, Stelfox H. The impact of checklists on inpatient safety outcomes: a systematic review of randomized controlled trials. J Hosp Med. 2017;12(8):675–82.
de Jager E, McKenna C, Bartlett L, Gunnarsson R, Ho YH. Postoperative adverse events inconsistently improved by the world health organization surgical safety checklist: a systematic literature review of 25 studies. World J Surg. 2016;40(8):1842–58.
Richardson B, Preskitt J, Lichliter W, Peschka S, Carmack S, de Prisco G, et al. The effect of multidisciplinary teams for rectal cancer on delivery of care and patient outcome: has the use of multidisciplinary teams for rectal cancer affected the utilization of available resources, proportion of patients meeting the standard of care, and does this translate into changes in patient outcome? Am J Surg. 2016;211(1):46–52.
Wood JJ, Metcalfe C, Paes A, Sylvester P, Durdey P, Thomas MG, et al. An evaluation of treatment decisions at a colorectal cancer multi-disciplinary team. Color Dis. 2008;10(8):769–72.
Kee F, Owen T, Leathem R. Decision making in a multidisciplinary cancer team: does team discussion result in better quality decisions? Med Decis Mak. 2004;24(6):602–13.
Lamb BW, Brown KF, Nagpal K, Vincent C, Green JS, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18(8):2116–25.
Cunningham U, Ward ME, De Brun A, McAuliffe E. Team interventions in acute hospital contexts: a systematic search of the literature using realist synthesis. BMC Health Serv Res. 2018;18(1):536.
Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49–61.
Schouten LM, Hulscher ME, van Everdingen JJ, Huijsman R, Grol RP. Evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008;336(7659):1491–4.
Campbell DA Jr, Kubus JJ, Henke PK, Hutton M, Englesbe MJ. The Michigan surgical quality collaborative: a legacy of Shukri Khuri. Am J Surg. 2009;198(5 Suppl):S49–55.
Goldberg P, Conti RM. Problems with public reporting of cancer quality outcomes data. J Oncol Pract. 2014;10(3):215–8.
Bundled payments for care improvement (BPCI) initiative: general information cms.gov. Centers for Medicare & Medicaid Services. https://innovation.cms.gov/initiatives/bundled-payments/. Accessed 11 Jan 2019.
STS public reporting online. The Society of Thoracic Surgeons. https://publicreporting.sts.org/search/cabg_report_card/hospital?title=&field_year_target_id=11&field_state_value=All. Accessed 11 Jan 2019.
Cancer program standards: ensuring patient-centered care. American College of Surgeons; 2016. https://www.facs.org/~/media/files/quality%20programs/cancer/coc/2016%20coc%20standards%20manual_interactive%20pdf.ashx. Accessed 11 Jan 2019.
Commission TJ. 2019. https://www.jointcommission.org/. Accessed 3 Apr 2019.
Commission TJ. National patient safety goals. The Joint Commission; 2019. https://www.jointcommission.org/hap_2017_npsgs/. Accessed 3 Apr 2019.
Forum NQ. 2019. https://www.qualityforum.org/Home.aspx. Accessed 3 Apr 2019.
Services USDoHaH. Agency for healthcare research and quality. https://www.ahrq.gov/research/index.html. Accessed 3 Apr 2019.
Institute P-COR. 2019. https://www.pcori.org/. Accessed 3 Apr 2019.
Quality AfHRa. Healthcare cost and utilization project (HCUP). https://www.ahrq.gov/data/hcup/index.html. Accessed 18 Mar 2019.
Surgeons ACo. ACS national surgical quality improvement program. https://www.facs.org/quality-programs/acs-nsqip. Accessed 18 Mar 2019.
Inc. V. https://www.vizientinc.com/. Accessed 18 Mar 2019.
Quality AfHRa. Culture of safety. https://psnet.ahrq.gov/primers/primer/5/Culture-of-Safety. Accessed 20 Mar 2019.
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Peterson, C.Y. (2020). Quality Improvement and Quality Metrics. In: Wang, T., Beck, A. (eds) Building a Clinical Practice. Success in Academic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-29271-3_15
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DOI: https://doi.org/10.1007/978-3-030-29271-3_15
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