Value Based Health Care

The AuthorYosef D. Dlugacz, PhD, is senior vice president and chief of Clinical Quality, Education, and Research, Krasnoff Quality Management Institute, a division of the North Shore–Long Island Jewish Health System.

• Figures and Tables ixPreface xiAcknowledgments xiiiThe Author xvIntroduction xviiPART ONE BASIC PRINCIPLES OF QUALITY MANAGEMENT 11 DRIVERS OF CHANGE 3Learning Objectives 3External Drivers 5Internal Drivers 11Summary 20Key Terms 20Things to Think About 202 IMPROVING PATIENT SAFETY 21Learning Objectives 21Understanding Quality Measures 23Working with Quality Information 24Measuring Value 27Asking Questions Via Data 30Presenting Results 34Effective Communication Improves Patient Safety 37Summary 39Key Terms 39Things to Think About 393 FOCUS ON THE PATIENT 41Learning Objectives 41Effective Communication and Patient-Focused Care 43Handoff Information Transfer 47SBAR 47Barriers to Effective Communication 48Strategies to Reduce Barriers 50Care and Communication Guidelines 51Patient Education 52Near-Miss Reporting 59Chronic Disease Management 61Task Forces 63Patient Rights and Responsibilities 65Compassionate Caring 65Summary 67Key Terms 68Things to Think About 684 UNDERSTANDING PROCESSES, OUTCOMES, AND COSTS 69Learning Objectives 69Some Events Should Never Occur 70Leaders’ Role in Good Outcomes 72Physicians’ Role in Good Outcomes 74Financial Value of Good Outcomes 76Changing the Traditional Culture 77Summary 86Key Terms 86Things to Think About 86PART TWO GETTING DOWN TO BUSINESS 875 THE VALUE OF PREVENTION 89Learning Objectives 89The Promotion of Prevention 90The Problems with Prevention 91The Patient’s Role 92Prevention Measures 93Regulatory Groups’ Role in Prevention 94Data’s Role in Promoting Prevention 95Management of Chronic Conditions 99Prevention in Ambulatory Care 101Proactive Prevention in the Hospital 106National Patient Safety Goals 107Technology and Prevention 108Summary 110Key Terms 111Things to Think About 1116 THE COST OF SENTINEL EVENTS 113Learning Objectives 113Changing the Incident Analysis Framework 115The Value of Root Cause Analysis 117Monitoring Behavioral Health 121Eliminating Never Events 124Improving Error Reports 125Quality Management’s Role in Controlling Adverse Events 126The Traditional Hierarchy Leads to Errors 128The Economics of Malpractice 129Summary 130Key Terms 131Things to Think About 1317 MANAGING EXPENSES IN A HIGH-RISK E NVIRONMENT 133Learning Objectives 133Improving Cost in the ICU 134Match the Resources to the Patient 136End-of-Life Care 137Sustaining Change 138Improving Operating Room Efficiency 141Improving Oversight 142Managing Throughput 143Summary 146Key Terms 147Things to Think About 1478 IMPROVING COMMUNICATION AND ESTABLISHING TRUST 149Learning Objectives 149Developing Trust 150The Role of Quality Management in Increasing Trust 151Transparency, Tracers, and Trust 151Establishing a Common Language 157Sustaining Change 159Monitoring Care 160Assessing Competency 163The Role of Regulatory Requirements in Ensuring Competency 164Medical Staff Credentialing 165Objectifying Competency 165Staffi ng Effectiveness 168Promoting Competency 169Summary 169Key Terms 170Things to Think About 1709 PROMOTING A SAFE ENVIRONMENT OF CARE 171Learning Objectives 171Communication Across Disciplines 172Working Together to Identify and Solve Problems 174Improving Processes 175Monitoring Safety 176Ensuring Accountability 178Maintaining a Safe Environment 180Establishing Oversight 180Communicating About Safety 181Assessing and Improving the Environment 182Summary 183Key Terms 184Things to Think About 18410 CONCLUSION 185REFERENCES 191USEFUL WEB SITES 195INDEX 197