Advancing Quality Improvement Research

The Institute of Medicine's Forum on the Science of Health Care Quality Improvement and Implementation held a workshop on January 16, 2007, in Washington, DC. The workshop had its roots in an earlier forum meeting when forum members discussed what is meant by the terms "quality improvement" and "implementation science" and became convinced that they mean different things to different people. At the time, the members also discussed the need to identify barriers to quality improvement research and to implementation science. Thus the purpose of this workshop was to bring people together from various arenas to discuss what quality improvement is, and what barriers exist in the health care industry to quality improvement and also to research about quality improvement. The summary that ensues is thus limited to the presentations and discussions during the workshop itself. We realize that there is a broader scope of issues pertaining to this subject area but are unable to address them in this summary document. The workshop's first session was devoted to experiences that various institutions have had with quality improvement. Recognizing the wealth of experiences available outside of health care services, the workshop included presenters from outside the health care service industry as well as from inside. This includes discussions from a variety of perspectives: non-health care services, health plans, hospitals, and nursing. Advancing Quality Improvement Research: Challenges and opportunities - Workshop Summary describes the events of the workshop.

The Institute of Medicine's Forum on the Science of Health Care Quality Improvement and Implementation held a workshop on January 16, 2007, in Washington, DC. The workshop had its roots in an earlier forum meeting when forum members discussed what is meant by the terms "quality improvement" and "implementation science" and became convinced that they mean different things to different people. At the time, the members also discussed the need to identify barriers to quality improvement research and to implementation science. Thus the purpose of this workshop was to bring people together from various arenas to discuss what quality improvement is, and what barriers exist in the health care industry to quality improvement and also to research about quality improvement. The summary that ensues is thus limited to the presentations and discussions during the workshop itself. We realize that there is a broader scope of issues pertaining to this subject area but are unable to address them in this summary document. The workshop's first session was devoted to experiences that various institutions have had with quality improvement. Recognizing the wealth of experiences available outside of health care services, the workshop included presenters from outside the health care service industry as well as from inside. This includes discussions from a variety of perspectives: non-health care services, health plans, hospitals, and nursing. Advancing Quality Improvement Research: Challenges and opportunities - Workshop Summary describes the events of the workshop.

Do interventions improve health outcomes? This volume provides a model and road map to answer clinical questions related to intervention effectiveness research, quality improvement, and program evaluations. It offers clear and simple guidance for all phases of a clinical inquiry projects from planning through dissemination and communication of results and findings. The book emphasizes the value and importance of leveraging existing data to advance research, practice, and quality improvement efforts. Intervention and Effectiveness Research is a practical guide for organizing and navigating the intersections of research and practice. Structure, process and outcome worksheets for every step are provided together with examples from diverse settings and populations to lead readers through the process of implementing their own projects. The author guides readers through the process of designing, implementing, and evaluating project s. This book is intended for teachers of DNP and PhD programs in nursing and other disciplines, their students, and healthcare leaders who need to leverage data to demonstrate care quality and outcomes.

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Creating a Business Case for Quality Improvement Research focuses on issues related to improving the science supporting health care quality and eliminating communication barriers that prevent advances in the field. In 2007, the Institute of Medicine convened a workshop designed to identify the economic and business disciplines that encourage sustained efforts to improve the quality of health care. Workshop presenters and participants included representatives from academia, government and industry. A business case for quality improvement depends heavily on the progress made in the following areas: systems change and leadership, data transparency, funding, enhanced training programs and ongoing dialogue between industry officials, patients and their families. They identified a major barrier to these efforts as the nationwide institutional reluctance to invest in quality improvement and documentation of outcomes, due largely to limited resources and competing priorities as to how these resources are spent in the industry. Too often priorities are placed on creating highly-visible technology-driven programs, with less emphasis in meeting the needs and expectations of the patients. In Creating a Business Case for Quality Improvement Research, a diverse group of stakeholders identifies and assesses these and other challenges to attain a better understanding of how to create a high-value health care system for the general population.

What is Total Quality Management (TQM)? How does it fit in with other forms of quality assurance? This book addresses these key questions. It explains how TQM might be applied successfully in the NHS and discusses the factors which will predict its successful implementation. It also outlines the approaches to quality assurance that are appropriate to a highly professionalized service like the NHS. Illustrated throughout with examples of putting TQM into practice, it provides models which include both the content of, and the organization for, TQM.

Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out "nuts-and-bolts" quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations.

In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.

The Health Care Data Guide is designed to help students and professionals build a skill set specific to using data for improvement of health care processes and systems. Even experienced data users will find valuable resources among the tools and cases that enrich The Health Care Data Guide. Practical and step-by-step, this book spotlights statistical process control (SPC) and develops a philosophy, a strategy, and a set of methods for ongoing improvement to yield better outcomes. Provost and Murray reveal how to put SPC into practice for a wide range of applications including evaluating current process performance, searching for ideas for and determining evidence of improvement, and tracking and documenting sustainability of improvement. A comprehensive overview of graphical methods in SPC includes Shewhart charts, run charts, frequency plots, Pareto analysis, and scatter diagrams. Other topics include stratification and rational sub-grouping of data and methods to help predict performance of processes. Illustrative examples and case studies encourage users to evaluate their knowledge and skills interactively and provide opportunity to develop additional skills and confidence in displaying and interpreting data. Companion Web site: www.josseybass.com/go/provost