Implementing Measurement and Statistics in Health Care CQI

Article

Spoeri, Randall K.; Jessee, William F.   (1993, ASQC)   Humana, Inc.

Annual Quality Congress, Boston MA    Vol. 47    No. 0
QICID: 9966    May 1993    pp. 267-273
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Article Abstract

The underlying philosophy of continuous quality improvement in health care is to apply the statistical and measurement techniques used in industrial quality management. At the Humana hospitals, problem solving occurs through a plan-do- check-act cycle: identify the problem; identify its key causes; generate potential solutions; select the optimum solution; implement; and evaluate the effectiveness of the solution. This problem solving is applied to four measurable components of quality health care: clinical outcomes; efficient use of resources; minimal risk associated with care; and patient satisfaction. For example, clinical outcomes have measures such as mortality (or survival) rates and complication rates. At least 34 clinical outcomes have been identified at Humana. Control charts of these data help the individual Humana hospitals analyze their performance. Humana has also enhanced a continuous improvement program by comparing its data to data in 700 non-Humana hospitals. The efficiency component is measured through data on length of stay, charges, and costs. The minimal risk component uses statistical techniques to account for the effect of patient characteristics like age and sex on clinical outcomes. Patient satisfaction measurements examines patient reactions to medication preparation, housekeeping, and other matters. This improvement program works when the measures focus on practicality, relevance, useful information, and simplifying the lives of clinicians and administrators.

Keywords

Continuous improvement (CI),Customer satisfaction (CS),Evaluation,Implementation,Plan-Do-Check-Act (PDCA) cycle,Statistics


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