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Quality Improvement

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Chronic Illness Care

Abstract

Quality improvement (QI) is a core component of health care and is the process by which providers and organizations strive to improve outcomes, decrease cost, improve accessibility, and enhance the care experience for providers and staff. There are four key principles that guide improvement projects: health care is a complex system, the focus is on the patient, teamwork is crucial, and data are essential. Several QI models and frameworks have applicability in health care. The Model for Improvement is focused on accelerating improvement through repeated Plan-Do-Study-Act cycles. Lean seeks to reduce waste in a system and bring value to the customer, while Six Sigma is employed to decrease variability in a process. Learning to manage change and data is critical for successful quality improvement initiatives. With the move from performance-based to value-based payment models, health-care providers will need to become adept with quality improvement skills.

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References

  1. Toussaint JS. Hospitals can’t improve without better management systems. Harv Bus Rev. p. 3/13/2017.

    Google Scholar 

  2. Blumenthal D, Dixon J. Health-care reforms in the USA and England: areas for useful learning. Lancet. 2012;380(9850):1352–7.

    Article  PubMed  Google Scholar 

  3. DelliFraine JL, Langabeer JR, Nembhard IM. Assessing the evidence of Six Sigma and Lean in the health care industry. Qual Manag Healthc. 2010;19(3):211–25.

    Article  Google Scholar 

  4. Liker JK, Morgan JM. The Toyota way in services: the case of lean product development. Acad Manag Perspect. 2006;20(2):5–20.

    Article  Google Scholar 

  5. Donaldson MS, Corrigan JM, Kohn LT. To err is human: building a safer health system, vol. 6: National Academies Press; 2000.

    Google Scholar 

  6. Richardson WC, Berwick DM, Bisgard JC, Bristow LR, Buck CR, Cassel CK. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Acadamies Press; 2001.

    Google Scholar 

  7. Viswanathan HN, Salmon JW. Accrediting organizations and quality improvement. Am J Manag Care. 2000;6(10):1117–30.

    CAS  PubMed  Google Scholar 

  8. PCMH 2014 Scoring: scoring summary [Internet]. vol. 2017. Available from: http://www.ncqa.org/programs/recognition/practices/patient-centered-medical-home-pcmh/pcmh-2014-content-and-scoring-summary

  9. Institute for Healthcare Improvement: About Us [Internet]. Vol. 2007. 2007. Available from: http://www.ihi.org/about/Pages/History.aspx

  10. Berwick DM, Nolan TW, Whittington J. The triple aim: care, health, and cost. Health Aff (Millwood). 2008;27(3):759–69.

    Article  Google Scholar 

  11. Puffer JC, Borkan J, DeVoe JE, Davis A, Phillips RL Jr, Green LA, et al. Envisioning a new health care system for America. Fam Med. 2015;47(8):598–603.

    PubMed  Google Scholar 

  12. Vockley M. The rise of telehealth:“triple aim, innovative technology, and popular demand are spearheading new models of health and wellness care”. Biomed Instrum Technol. 2015;49(5):306–20.

    Article  PubMed  Google Scholar 

  13. Bodenheimer T, Sinsky C. From triple to quadruple aim: care of the patient requires care of the provider. Ann Fam Med. 2014;12(6):573–6.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Berwick DM, Calkins DR, McCannon CJ, Hackbarth AD. The 100 000 lives campaign: setting a goal and a deadline for improving health care quality. JAMA. 2006;295(3):324–7.

    Article  CAS  PubMed  Google Scholar 

  15. Wachter RM, Pronovost PJ. The 100,000 lives campaign: a scientific and policy review. Jt Comm J Qual Patient Saf. 2006;32(11):621–7.

    Article  PubMed  Google Scholar 

  16. Barr M, Ginsburg J. The advanced medical home: a patient-centered, physician-guided model of health care. Phil Am Coll Phys. 2006.

    Google Scholar 

  17. Physicians AA of F. Joint principles of the patient-centered medical home. Del Med J. 2008;80(1):21–2.

    Google Scholar 

  18. Hirsch JA, Leslie-Mazwi TM, Nicola GN, Bhargavan-Chatfield M, Seidenwurm DJ, Silva E, et al. PQRS and the MACRA: value-based payments have moved from concept to reality. AJNR Am J Neuroradiol. 2016;37(12):2195–200.

    Article  CAS  PubMed  Google Scholar 

  19. Quality Improvement [Internet]. vol. 2017, U.S. DHHS: Health Resources and Service Administration 2011. Available from: https://www.hrsa.gov/quality/toolbox/methodology/qualityimprovement/index.html

  20. Langley GJ, Moen RD, Nolan KM, Nolan TW, Norman CL, Provost LP. The improvement guide: a practical approach to enhancing organizational performance. San Francisco: Jossey-Bass Publishers; 2009.

    Google Scholar 

  21. Moen RD, Norman CL. Circling back. Qual Prog. 2010;43(11):22.

    Google Scholar 

  22. Koenigsaecker G. Leading the lean enterprise transformation. 2nd ed. New York: CRC Press; 2012.

    Google Scholar 

  23. Liker JK. The toyota way. Esensi; 2004.

    Google Scholar 

  24. Miller D. No title. Going Lean Heal CareIHI Innov Ser White Pap Inst Healthc Improv 2005. 2013.

    Google Scholar 

  25. Womack JP, Jones DT. Lean thinking: banish waste and create wealth in your corporation. New York: Simon and Schuster; 2010.

    Google Scholar 

  26. Eaton M. The Lean practitioner’s handbook. London: Kogan Page Publishers; 2013.

    Google Scholar 

  27. Graban M, Swartz JE. Healthcare kaizen: engaging front-line staff in sustainable continuous improvements. New York: CRC Press; 2012.

    Google Scholar 

  28. Sobek II DK, Smalley A. Understanding A3 thinking: a critical component of Toyota’s PDCA management system. New York: CRC Press; 2011.

    Google Scholar 

  29. Harry MJ, Schroeder R. Six sigma: the breakthrough management strategy revolutionizing the world’s top corporations. New York: Broadway Business; 2005.

    Google Scholar 

  30. Kubiak TM, Benbow DW. The certified six sigma black belt handbook. Milwaukee, WI: ASQ Quality Press; 2009.

    Google Scholar 

  31. George ML. Lean six sigma: combining six sigma quality with lean production speed. New York: McGraw-Hill; 2002.

    Google Scholar 

  32. Gittner LS, Husaini BA, Hull PC, Emerson JS, Tropez-Sims S, Reece MC, et al. Use of six sigma for eliminating missed opportunities for prevention services. J Nurs Care Qual. 2015;30(3):254–60.

    Article  PubMed  Google Scholar 

  33. Paccagnella A, Mauri A, Spinella N. Quality improvement for integrated management of patients with type 2 diabetes (PRIHTA project stage 1). Qual Manag Health Care. 2012;21(3):146–59.

    Article  PubMed  Google Scholar 

  34. Kenney C. Transforming health care: Virginia Mason Medical Center’s pursuit of the perfect patient experience. Boca Raton: CRC Press; 2012.

    Google Scholar 

  35. Toussaint JS, Berry LL. Toussaint and Berry, 2013 -The promise of lean in health care. 2013;88(January):74–82.

    Google Scholar 

  36. Jha AK, Perlin JB, Kizer KW, Dudley RA. Effect of the transformation of the veterans affairs health care system on the quality of care. N Engl J Med [Internet]. 2003;348(22):2218–27. Available from: http://content.nejm.org/cgi/content/abstract/348/22/2218%5Cnhttp://www.ncbi.nlm.nih.gov/pubmed/12773650.

    Article  Google Scholar 

  37. Mannon M. Lean healthcare and quality management: the experience of ThedaCare. Qual Manag J. 2014;21(1):7.

    Article  Google Scholar 

  38. Toussaint JS, Berry LL. Leadership lessons from lean. Trustee. 2013;66(10):21–4.

    PubMed  Google Scholar 

  39. Wideman M, Whittler M. Barcode medication administration: lessons learned from an intensive care unit implementation. Adv Patient Saf [Internet]. 2005;3:437–52. Available from: http://www.ahrq.gov/downloads/pub/advances/vol3/wideman.pdf.

    Google Scholar 

  40. Khuri SF, Daley J, Henderson WG. The comparative assessment and improvement of quality of surgical care in the Department of Veterans Affairs. Arch Surg. 2002;137:20–7.

    Article  PubMed  Google Scholar 

  41. Kotter JP. Leading change: why transformation efforts fail. Boston: Harvard College; 1995.

    Google Scholar 

  42. Kotter JP. Leading change. Boston: Harvard Business Press; 1996.

    Google Scholar 

  43. Health Resources and Services Administration. Managing data for performance improvement [Internet]. Vol. 2017, U.S. DHHS: Health Resources and Service Administration. 2011. Available from: http://www.hrsa.gov/quality/toolbox/methodology/performanceimprovement/index.html.

  44. Barnas K. Beyond heroes: a lean management system for healthcare. ThedaCare Center for Healthcare Value; 2014.

    Google Scholar 

  45. Bogetz JF, Rassbach CE, Bereknyei S, Mendoza FS, Sanders LM, Braddock CH. Training health care professionals for 21st-century practice: a systematic review of educational interventions on chronic care. Acad Med. 2015;90(11):1561–72.

    Article  PubMed  Google Scholar 

  46. Newton WP, Atkinson H, Parker DL, Gwynne M. Bringing patients into the patient-centered medical home: lessons learned in a large primary care practice. N C Med J. 2015;76(3):190–3.

    PubMed  Google Scholar 

  47. Tsai TC. Better patient care at high-quality hospitals may save medicare money and bolster episode-based payment models. Health Aff (Millwood). 2016 Sep;35(9):1681–9.

    Article  Google Scholar 

  48. Berwick D. Era 3 for medicine and health care. JAMA. 2016;315(13):1329–30.

    Article  CAS  PubMed  Google Scholar 

  49. Ogundeji YK, Bland JM, Sheldon TA. The effectiveness of payment for performance in health care: a meta-analysis and exploration of variation in outcomes. Health Policy (New York) [Internet]. 2016;120(10):1141–50. Available from: http://www.sciencedirect.com/science/article/pii/S0168851016302196.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Family Medicine, University of North Carolina, Chapel Hill, NC, USA

    Dana M. Neutze

  2. Practice Quality and Innovation, UNC Health Care System, Chapel Hill, NC, USA

    Lindsay Stortz

Authors
  1. Dana M. Neutze
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  2. Lindsay Stortz
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Correspondence to Dana M. Neutze .

Editor information

Editors and Affiliations

  1. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Timothy P. Daaleman

  2. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Margaret R. Helton

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Neutze, D.M., Stortz, L. (2018). Quality Improvement. In: Daaleman, T., Helton, M. (eds) Chronic Illness Care. Springer, Cham. https://doi.org/10.1007/978-3-319-71812-5_35

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  • DOI: https://doi.org/10.1007/978-3-319-71812-5_35

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71811-8

  • Online ISBN: 978-3-319-71812-5

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