Lloyd, Robert C.

Quality Health Care : A Guide to Developing and Using Indicators

Introduction ix Preface xiii Acknowledgments xix Setting the Context 1(18) A Brief Review of Health Care Reform 2(6) The Growing Concern Over Service 8(2) Defining Continuous Quality Improvement (CQI) 10(4) Notes 14(5) Measuring the Voice of the Customer 19(34) It All Starts with Listening 19(1) Creating a Service Excellence Culture 20(10) Who Are Your Customers? 30(4) Defining Key Quality Characteristics 34(3) Listening Three Times 37(2) Understanding the Tools 39(7) Combining VOC Data with the VOP 46(3) Notes 49(4) Indicator Selection and Development 53(70) Measurement Roadblocks 56(6) The Quality Measurement Roadmap 62(3) Types of Indicators 65(3) Selecting a Specific Indicator 68(3) Developing Operational Definitions 71(4) Developing Data Collection Plans 75(20) The Indicator Development Form 95(12) Case Study: Transcription Turnaround Time 107(7) Notes 114(9) Organizing Indicators Into Strategic Dashboards 123(28) Evolution of the Strategic Dashboard 127(4) Focusing on the Vital Few 131(4) The Role of Benchmarking 135(4) A Comment on the ``New'' Business Management Strategies 139(6) Notes 145(6) Tapping the Knowledge That Hides In Data 151(22) Data versus Information 151(5) Research for Efficacy 156(2) Research for Effectiveness and Efficiency 158(1) The Debate is Silly 159(1) Static versus Dynamic Approaches to Data Analysis 160(6) Case Study: The Monday Morning Dilemma 166(2) Notes 168(5) Overcoming Numerical Illiteracy 173(56) Understanding Variation 173(10) Distinguishing Common from Special Causes of Variation 183(2) Using SPC Methods 185(34) Making the Appropriate Management Decisions 219(3) Notes 222(7) Applying Quality Measurement Principles 229(66) Case Study #1: Predicting a Cardiovascular Event 229(5) Case Study #2: Sampling Central Line Infections 234(1) Case Study #3: Sampling Medicare Insurance Audits 235(1) Case Study #4: Tracking Patient Falls 236(4) Case Study #5: Pressure Ulcer Prevention 240(4) Case Study #6: Evaluating Staffing Effectiveness 244(12) Case Study #7: To Flash or Not to Flash---That Is the Question? 256(5) Case Study #8: Clarifying the Operational Definition of Readmission 261(1) Case Study #9: Managing a Breast Cancer Patient's Coumadin Levels 262(5) Case Study #10: Group B Streptococcus in Pregnant Women 267(4) Case Study #11: Emergency Department Fast Track 271(3) Case Study #12: Tracking Patient Complaints 274(3) Case Study #13: Reducing Ventilator-Associated Pneumonia 277(3) Case Study #14: Pain Management for Hip and Knee Replacement Patients 280(11) Notes 291(4) Connecting the Dots 295(34) Understanding the Dots 296(1) Personal Transformation 297(14) Organizational Transformation 311(10) Societal Transformation 321(3) Notes 324(5) Index 329