Quality management in health care (Qual Manag Health Care)

Publisher: Lippincott, Williams & Wilkins

Journal description

This peer-reviewed quarterly journal provides a forum to explore the theoretical, technical, and strategic elements of total quality management in health care. Each issue of Quality Management in Health Care (QMHC) features a timely symposium that addresses a key issue in health care quality management. Also included in each issue is an in-depth interview with a key individual in health care quality management, an educational tutorial on basic quality management tools and processes, an information clearinghouse to encourage informal communication among those involved in the field of health care quality management, and a reference center that reviews books, journal articles, seminars, and videos of interest.

Current impact factor: 0.00

Impact Factor Rankings

Additional details

5-year impact 0.00
Cited half-life 0.00
Immediacy index 0.00
Eigenfactor 0.00
Article influence 0.00
Website Quality Management in Health Care website
Other titles Quality management in health care, QMHC
ISSN 1063-8628
OCLC 26178154
Material type Periodical
Document type Journal / Magazine / Newspaper

Publisher details

Lippincott, Williams & Wilkins

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • Some journals have separate policies, please check with each journal directly
    • Pre-print must be removed upon acceptance for publication
    • Post-print may be deposited in personal website or institutional repository
    • Publisher's version/PDF cannot be used
    • Must include statement that it is not the final published version
    • Published source must be acknowledged with full citation
    • Set statement to accompany deposit
    • Must link to publisher version
    • NIH authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 12 months embargo (see policy for details)
    • Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf after a 6 months embargo (see policy for details)
    • Publisher last reviewed on 19/03/2015
  • Classification
    yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Although Lean management techniques are increasingly used in health care to improve quality and reduce costs, lessons about how to successfully implement this approach on the front lines of care delivery are not well documented. In this study, we highlight key facilitators and barriers to implementing Lean among frontline primary care providers. Methods: This case study took place at a large, ambulatory care delivery system serving nearly 1 million patients. In-depth interviews were conducted with primary care physicians, staff, and administrators to identify key factors impacting Lean redesigns in primary care. Results: Overall, staff engagement and performance management, sensitivity to the professional values and culture of medicine, and perceived adequacy of organizational resources were critical when introducing Lean changes. Specific drivers of change included empowerment of staff at all levels, visual display of performance metrics, and a culture of innovation and collaboration. Barriers included physician resistance to standardized work, difficulty transferring management responsibilities to non-physician staff, and time and staffing required for participating in improvement efforts. Conclusion: Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.
    No preview · Article · Jul 2015 · Quality management in health care

  • No preview · Article · Apr 2014 · Quality management in health care
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    No preview · Article · Jan 2014 · Quality management in health care
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    ABSTRACT: Reducing hospital readmissions is a key approach to curbing health care costs and improving quality and patient experience in the United States. Despite the proliferation of strategies and tools to reduce readmissions in the general population and among Medicare beneficiaries, few resources exist to inform initiatives to reduce readmissions among Medicaid beneficiaries. Patients covered by Medicaid also experience readmissions and are likely to experience distinct challenges related to socioeconomic status. This review aims to identify factors related to readmissions that are unique to Medicaid populations to inform efforts to reduce Medicaid readmissions. Our search yielded 254 unique results, of which 37 satisfied all review criteria. Much of the Medicaid readmissions literature focuses on patients with mental health or substance abuse issues, who are often high utilizers of health care within the Medicaid population. Risk factors such as medication noncompliance, postdischarge care environments, and substance abuse comorbidities increase the risk of readmission among Medicaid patients.
    No preview · Article · Jan 2014 · Quality management in health care
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    ABSTRACT: Popular quality improvement tools such as Six Sigma (SS) claim to provide health care managers the opportunity to improve health care quality on the basis of sound methodology and data. However, it is unclear whether this quality improvement tool is being used correctly and improves health care quality. The authors conducted a comprehensive literature review to assess the correct use and implementation of SS and the empirical evidence demonstrating the relationship between SS and improved quality of care in health care organizations. The authors identified 310 articles on SS published in the last 15 years. However, only 55 were empirical peer-reviewed articles, 16 of which reported the correct use of SS. Only 7 of these articles included statistical analyses to test for significant changes in quality of care, and only 16 calculated defects per million opportunities or sigma level. This review demonstrates that there are significant gaps in the Six Sigma health care quality improvement literature and very weak evidence that Six Sigma is being used correctly to improve health care quality.
    No preview · Article · Jan 2014 · Quality management in health care

  • No preview · Article · Jan 2014 · Quality management in health care
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    ABSTRACT: Rising health care costs will result in reduced payments to providers, but across-the-board provider payment reductions are not the answer. Instead, existing payment systems should be reformed to strengthen value for the dollars spent. This can be accomplished by increasing efficiency, improving quality and outcomes, and lowering costs. Payment system reforms must be practical, transparent, identify opportunities for care improvement, and demonstrate material cost savings. Most importantly, because the current growth in health care costs is unsustainable, these reforms must be able to be implemented today. A set of comprehensive measures is being used by state government and private payers in the United States to adjust payment, based on improved outcomes quality. This article details the use of this set of measures, referred to as potentially preventable events, and demonstrates how they are being applied to achieve health care value.
    No preview · Article · Jan 2014 · Quality management in health care
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    ABSTRACT: Background: Since most radiologists do not meet with patients, questionnaires often substitute for face-to-face interviews to collect patients' history. We report the effect of direct radiologist-patient interviews on the quality of patient history recorded for musculoskeletal magnetic resonance imaging. Methods: Magnetic resonance imaging questionnaires completed by outpatients were separated into 2 cohorts: (1) imaging center (IC) forms with no radiologist interviews; (2) hospital (H) forms with radiologist-patient interviews. Three blinded radiologists independently scored each questionnaire for quality on a 5-point scale. A separate quantitative analysis was also performed. The unpaired t test, Fischer exact test, and χ² test were used to compare the cohorts. Results: The mean score of the H cohort among reviewers was superior to the IC cohort: 3.79 (±0.98) versus 3.04 (±1.00), P < .0001. Each reviewer also independently found the H cohort to be of higher quality for patient history, P < .0001. For the IC cohort, 7.8% of questionnaires did not report a single symptom versus 0.0% in the H cohort, P = .0331. Also, the IC cohort recorded symptoms in 2 or less words more often than the H cohort, P < .0001. Conclusion: Brief radiologist-patient interviews are superior for obtaining a higher quality of patient history for musculoskeletal MRI than patient questionnaires alone.
    No preview · Conference Paper · Dec 2013
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    No preview · Article · Jan 2013 · Quality management in health care
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    ABSTRACT: The content and spectrum of rural health care services are different from those in urban areas. The extent to which health care consumers' perceptions of the quality of these services vary across settings and the association of these perceptions with features of rural and urban settings are unclear. To determine whether perceptual differences of quality exist and contrast rural/urban associations between contextual characteristics and perceived quality of health care. Multilevel, cross-sectional analysis of a state-representative sample of 33 786 adults, stratified by rural/urban status linked with county-level data describing contextual features (eg, health care, economics, and social capital). The dependent variable was respondents' perceived quality of health care received in the past year. Weighted multilevel random intercept models examined the independent association of contextual characteristics with perceived quality. Overall perceived quality did not differ between rural and urban settings. Similarly, the pattern of associations between perceived quality and contextual characteristics was generally comparable between settings. A notable difference was an association between higher quality with an increasing proportion of hospitals offering more than 25 services in urban areas (beta = .763; P < .05). Despite rural/urban differences in contextual characteristics with potential influence on health care delivery, overall consumer perception of health care quality was similar in both settings. This suggests that health care managers may be adopting setting-specific strategies to enhance consumer satisfaction despite contextual differences.
    No preview · Article · Oct 2009 · Quality management in health care

  • No preview · Article · Oct 2009 · Quality management in health care
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    ABSTRACT: In this study, we examined the proposition that the occurrence of adverse medical events (AMEs) increases spending on inpatient hospital care. Employing the individual and the episode of care as the unit of analysis, the study relied on data assembled in the Public Use Data File maintained by the Oklahoma State Department of Health. Multiple regression analyses were used to examine the covariates of the revenue per case and its components, the average revenue per day, and the number of days per case. The results indicate that the occurrence of AMEs would increase the revenue per case, the days of care per case, and the revenue per day. Study findings suggest that a decline in AMEs improves quality while lowering spending on hospital care and the use of inpatient services.
    No preview · Article · Oct 2009 · Quality management in health care
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    ABSTRACT: The complexity of the operating room (OR) requires that both structural (eg, department layout) and behavioral (eg, staff interactions) patterns of work be considered when developing quality improvement strategies. In our study, we investigated how these contextual factors influence outpatient OR processes and the quality of care delivered. The study setting was a German university-affiliated hospital performing approximately 6000 outpatient surgeries annually. During the 3-year-study period, the hospital significantly changed its outpatient OR facility layout from a decentralized (ie, ORs in adjacent areas of the building) to a centralized (ie, ORs in immediate vicinity of each other) design. To study the impact of the facility change on OR processes, we used a mixed methods approach, including process analysis, process modeling, and social network analysis of staff interactions. The change in facility layout was seen to influence OR processes in ways that could substantially affect patient outcomes. For example, we found a potential for more errors during handovers in the new centralized design due to greater interdependency between tasks and staff. Utilization of the mixed methods approach in our analysis, as compared with that of a single assessment method, enabled a deeper understanding of the OR work context and its influence on outpatient OR processes.
    No preview · Article · Oct 2009 · Quality management in health care

  • No preview · Article · Oct 2009 · Quality management in health care
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    ABSTRACT: Capacity for change, or the ability and willingness to undertake change, is an organizational characteristic with potential to foster quality management in health care. We report on the development and psychometric properties of a quantitative measure of capacity for change for use in primary care settings. Following review of previous conceptual and empirical studies, we generated 117 items that assessed organizational structure, climate, and culture. Using information from direct observation and key informant interviews, a research team member rated these items for 15 primary care practices engaged in a quality improvement intervention. Distributional statistics, pairwise correlation analysis, Rasch modeling, and item content review guided item reduction and instrument finalization. Reliability and convergent validity were assessed. Ninety-two items were removed because of limited response distributions and redundancy or because of poor Rasch model fit. The final instrument comprising 25 items had excellent reliability (alpha = .94). A Rasch model-derived capacity for change score correlated well with an independently determined, qualitatively derived summary assessment of each practice's capacity for change (rhoS = 0.82), suggesting good convergent validity. We describe a new instrument for quantifying organizational capacity for change in primary care settings. The ability to quantify capacity for change may enable better recognition of practices likely to be successful in their change efforts and those first requiring capacity building prior to change interventions.
    No preview · Article · Oct 2009 · Quality management in health care
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    ABSTRACT: To improve processes in hospitals, a case study was conducted at a German university hospital, which consists of more than 30 clinics and institutes on a large campus. The case study focused on the analysis of the patient flow and of machine utilization in the radiology department. Radiological devices are spread over the campus and located in different buildings. Patients with restricted mobility have to be transported by a vehicle transportation service across the campus. However, a vehicle transport can considerably influence the patients' punctual arrival to their appointments. The observations of the case study showed that the current organization of the radiology department results in high patient waiting times and machine idle times. The university hospital is planning to conduct significant organizational changes, especially with regard to the organization of the radiology department. This case study was conducted to support the planning processes of the clinic and to reveal and estimate optimization potential. To analyze the patient flow, a discrete event multicriteria simulation model was designed and implemented. By modeling different scenarios, it was possible to easily compare and assess distinct alternatives. This led to improved machine utilization and reduced waiting times.
    No preview · Article · Oct 2009 · Quality management in health care
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    ABSTRACT: Although often used in health care settings as a method for continuous quality improvement, experience with the breakthrough collaborative in nonclinical health care settings is limited. In this article, we report pilot data from a social services collaborative conducted in 2007 to 2009 in Sweden, with special attention given to features of the implementation context that appeared to facilitate or hinder its success. We used a case study approach to describe the processes used in the pilot project as well as to characterize the context. Our analysis was guided by a framework consisting of earlier identified factors for success including "motivate and empower the teams" and "ensure teams have measurable and achievable targets." We observed several context-specific factors. These included measuring challenges connected to large cooperating teams. Specifically, teams representing different organizations needed more time to carry out a breakthrough collaborative than those in clinical health care settings. As in breakthrough collaboratives conducted in health care settings, early measurement efforts enabled a clearer sense of direction, which may have served to reinforce motivation among team members. This study highlights features that may have universal importance in influencing the success of breakthrough collaboratives to improve the quality of social services.
    No preview · Article · Oct 2009 · Quality management in health care