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This review is an update of an earlier review where we aim to present available documentation of about the effect of certification and accreditation of hospitals. We searched for systematic reviews and primary studies with the following designs: randomized controlled trials, controlled before and after studies, and interrupted time series. We included studies regarding all types of hospitals as long as the intervention included certification or accreditation. The literature search identified 522 unique references. None of them fulfilled our inclusion criteria regarding study design. There is a lack of documentation to assess the effect of certification and accreditation of hospitals.
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This review is an update of an earlier review where we aim to present available documentation of about the effect of certification and accreditation of hospitals. We searched for systematic reviews and primary studies with the following designs: randomized controlled trials, controlled before and after studies, and interrupted time series. We included studies regarding all types of hospitals as long as the intervention included certification or accreditation. The literature search identified 522 unique references. None of them fulfilled our inclusion criteria regarding study design. There is a lack of documentation to assess the effect of certification and accreditation of hospitals.
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patient safety --- quality improvement --- child health --- paediatrics
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Leadership --- Organization and Administration --- Quality Improvement
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"This book focuses on daily continuous improvement, or kaizen, for healthcare professionals and organizations. It shares some mechanics for facilitating kaizen, but more importantly covers the management mindsets and philosophies required to make kaizen work effectively in a department or as an organization-wide program. All of the examples are real healthcare examples shared by Franciscan Alliance Health System and other leading organizations, with many color pictures and illustrations of kaizens. This book will be helpful to healthcare organizations that have embraced weeklong improvement events, but now want to move beyond just doing events into a more complete lean management system"--Provided by publisher.
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Cet ouvrage constitue un véritable guide méthodologique pour tous ceux qui veulent mettre en oeuvre une démarche d’amélioration continue de la qualité durable et participative au sein de leurs organisations sociales ou médicosociales et en réaliser une auto-évaluation la plus complète possible. Il articule des apports conceptuels et théoriques avec des outils techniques et des questionnements pratiques issus des nombreuses interventions de terrain de l’auteur, et met à disposition un référentiel d’une rare exhaustivité, comprenant des indicateurs très concrets identifiés avec de nombreux professionnels de terrain et pouvant s’appliquer à une grande palette d’établissements et services : Qualiservice SMS©. Cette deuxième édition, fortement enrichie et actualisée, s’inscrit dans les orientations et recommandations de l’ANESM tout en allant bien au-delà.
Social Work --- Health Services --- Quality Control --- Quality Improvement --- Benchmarking
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Background: Provisions of the Affordable Care Act (2010) require the use of validated quality measures (QMs) to evaluate the quality of health care programs, services, and outcomes. The need for such measures is crucial in serious mental illness (SMI), a long-term illness involving substantial functional impairment over multiple symptom domains that affects more than 11 million U.S. adults. Using QMs to assess the effect of programs designed to improve the mental health of SMI populations is an important task in improving the quality of these programs and services and, ultimately, health outcomes. Although stakeholders have proposed a variety of QMs, none are used consistently across all treatment sites or all forms of SMI. Key areas of uncertainty remain. Knowledge gaps for SMI include an agreed-upon list of relevant QMs; identification of the most meaningful outcomes by which to measure the success of QMs; identification of barriers to and facilitators of their implementation; and robust assessments of whether use of such measures improves medical, psychiatric, and patient-centered outcomes. -- Purpose: The goal of this Technical Brief is to identify how QMs are currently used in the SMI population and to describe the evidence supporting their use. -- Methods: We discussed with Key Informants and performed targeted searches of published and gray literature on questions of (1) a description of QMs; (2) the context for their use; (3) research linking QMs to changes in outcomes; and (4) current key issues in future uptake, use, evidence gaps, and research priorities. -- Findings: The evidence base, which was sparse, suggests that no uniformly accepted practices exist on how to define or implement QMs for SMI, nor on which QMs are the most relevant. Outcomes against which to evaluate the effectiveness of QMs are difficult to measure. Time, the additional burden of using QMs on a resource-limited health care system, and a thin evidence base on their use were key barriers to implementation of QMs. Indeed, we found no prospective research evaluating whether the use of QMs for SMI leads to changes in outcomes. Of note, evidence does not exist that indicates that certain measures often used as proxies for quality of care actually measure quality of care or improve outcomes. -- Conclusions: The literature does not indicate an agreed-upon list of preferred relevant QMs for the SMI population, and the outcomes against which to assess the effectiveness of QMs are challenging to measure. Relatedly, and possibly of greatest practical importance, no studies have assessed whether the use of QMs improves health outcomes for patients with SMI nor do stakeholders agree on preferred outcomes. Accordingly, critical issues for the field to address include (1) determining the level of evidence (or strength of evidence) necessary to support implementation of QMs, given the complexities of studying the topic and the likely limited research funding; (2) developing the evidence base that assesses the link between QM use and outcomes; (3) considering when to invest the time and resources on measuring outcomes of care to evaluate the impact of QMs, and when process measures (proxies of the outcomes) are a reasonable and more feasible alternative; (4) determining the resource needs for QM implementation; and (5) developing validated and reliable QM tools that can be implemented feasibly in real-world practice.
Mental Disorders --- Treatment Outcome --- Quality Improvement --- therapy. --- United States
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Background: Provisions of the Affordable Care Act (2010) require the use of validated quality measures (QMs) to evaluate the quality of health care programs, services, and outcomes. The need for such measures is crucial in serious mental illness (SMI), a long-term illness involving substantial functional impairment over multiple symptom domains that affects more than 11 million U.S. adults. Using QMs to assess the effect of programs designed to improve the mental health of SMI populations is an important task in improving the quality of these programs and services and, ultimately, health outcomes. Although stakeholders have proposed a variety of QMs, none are used consistently across all treatment sites or all forms of SMI. Key areas of uncertainty remain. Knowledge gaps for SMI include an agreed-upon list of relevant QMs; identification of the most meaningful outcomes by which to measure the success of QMs; identification of barriers to and facilitators of their implementation; and robust assessments of whether use of such measures improves medical, psychiatric, and patient-centered outcomes. -- Purpose: The goal of this Technical Brief is to identify how QMs are currently used in the SMI population and to describe the evidence supporting their use. -- Methods: We discussed with Key Informants and performed targeted searches of published and gray literature on questions of (1) a description of QMs; (2) the context for their use; (3) research linking QMs to changes in outcomes; and (4) current key issues in future uptake, use, evidence gaps, and research priorities. -- Findings: The evidence base, which was sparse, suggests that no uniformly accepted practices exist on how to define or implement QMs for SMI, nor on which QMs are the most relevant. Outcomes against which to evaluate the effectiveness of QMs are difficult to measure. Time, the additional burden of using QMs on a resource-limited health care system, and a thin evidence base on their use were key barriers to implementation of QMs. Indeed, we found no prospective research evaluating whether the use of QMs for SMI leads to changes in outcomes. Of note, evidence does not exist that indicates that certain measures often used as proxies for quality of care actually measure quality of care or improve outcomes. -- Conclusions: The literature does not indicate an agreed-upon list of preferred relevant QMs for the SMI population, and the outcomes against which to assess the effectiveness of QMs are challenging to measure. Relatedly, and possibly of greatest practical importance, no studies have assessed whether the use of QMs improves health outcomes for patients with SMI nor do stakeholders agree on preferred outcomes. Accordingly, critical issues for the field to address include (1) determining the level of evidence (or strength of evidence) necessary to support implementation of QMs, given the complexities of studying the topic and the likely limited research funding; (2) developing the evidence base that assesses the link between QM use and outcomes; (3) considering when to invest the time and resources on measuring outcomes of care to evaluate the impact of QMs, and when process measures (proxies of the outcomes) are a reasonable and more feasible alternative; (4) determining the resource needs for QM implementation; and (5) developing validated and reliable QM tools that can be implemented feasibly in real-world practice.
Mental Disorders --- Treatment Outcome --- Quality Improvement --- therapy. --- United States
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Continuous Quality Improvement (CQI) methods are increasingly widely used to bridge the gaps between the evidence base for best clinical practice, what actually happens in practice, and the achievement of better population health outcomes. Among a range of quality improvement strategies, CQI methods are characterised by iterative and ongoing use of specific processes to identify quality problems, develop solutions, and implement and evaluate changes. The application of CQI processes in health is evolving and evidence of their success continues to emerge. There is, however, a need to enhance understanding of how best to implement, scale-up and evaluate CQI programs for the purpose of improving quality of care and population health outcomes in different contexts. This research topic aims to attract articles that add to knowledge of useful approaches to tailoring CQI methods for different contexts or purposes, and for implementation, scale-up and evaluation of CQI interventions/programs.
evaluation --- primary healthcare --- barriers --- Continuous quality improvement --- systems --- enablers --- design --- CQI --- variation --- quality --- evaluation --- primary healthcare --- barriers --- Continuous quality improvement --- systems --- enablers --- design --- CQI --- variation --- quality
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Mayo Clinic Proceedings: Innovations, Quality & Outcomes (MCP:IQ&O) publishes original research, reviews, commentaries, editorials, and other materials that focus on clinical innovations, quality improvement, and optimal outcomes, in medicine and surgery.
clinical innovations --- quality improvement --- medicine --- clinical outcomes --- surgery --- Medical care --- Evaluation.
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