Models of Care for High-Need, High-Cost Patients

"This brief analyzes experts’ reviews of evidence about care models designed to improve outcomes and reduce costs for patients with complex needs. It finds that successful models have several common attributes"

Models of Care for High-Need, High-Cost Patients: An Evidence Synthesis
D McCarthy, J Ryan, S Klein
The Commonwealth Fund
October 2015

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Access, quality, and costs of care at physician owned hospitals in the United States

"Using a comprehensive list of POHs [physician owned hospitals] across the United States and contemporary data, we found no evidence that POHs systematically avoid poorer patients or those from ethnic and racial minority groups. POHs also performed equally to non-POHs on a wide array of measures of quality of care, costs, and payments for care. These findings indicate a need to re-examine existing public policies that target all hospitals with physician owners."

Access, quality, and costs of care at physician owned hospitals in the United States: observational study
DM Blumenthal, EJ Orav, AB Jena, DM Dudzinski, ST Le,  AK Jha, KT Li
BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h4466


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Using data and analytics to transform patient care

"Data-driven decision making has improved patient outcomes in Intermountain's cardiovascular medicine, endocrinology, surgery, obstetrics and care processes — while saving millions of dollars in procurement and in its the supply chain." 

How Intermountain Healthcare is using data and analytics to transform patient care
M Fitzgerald
MITSloan Management Review
June 2015

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Improving Patient Safety Culture through Teamwork and Communication

"This new HPOE guide outlines the TeamSTEPPS framework, describes teamwork tools and includes examples and case studies illustrating how hospitals and care systems are using TeamSTEPPS to improve patient safety and quality."

Improving Patient Safety Culture through Teamwork and Communication: TeamSTEPPS®
Health Research & Educational Trust
June 2015

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Improving Care for Chronic Conditions

"The goal of this project is to document the current range of chronic care management services, identify best practices, and elicit industry trends. We also attempt to identify factors in the plans’ operating environment that limit their ability to optimize chronic care programs."

Improving Care for Chronic Conditions: Current Practices and Future Trends in Health Plan Programs
S Mattke, T Mengistu, L Klautzer, EM Sloss, RH Brook
RAND Corporation
2015

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Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires

"Current estimates for wrong-site surgery and retained surgical items are 1 event per 100 000 and 1 event per 10 000 procedures, respectively, but the precision is uncertain, and the per-procedure prevalence of surgical fires is not known. "

Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires: A Systematic Review of Surgical Never Events 
S Hempe et al.
JAMA Surgery June 10, 2015. doi:10.1001/jamasurg.2015.0301

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Multifocal Clinical Performance Improvement Across 21 Hospitals

"Improving quality and safety across an entire healthcare system in multiple clinical areas within a short time frame is challenging. We describe our experience with improving inpatient quality and safety at Kaiser Permanente Northern California."

Multifocal Clinical Performance Improvement Across 21 Hospitals
Crawford, Barbara; Skeath, Melinda; Whippy, Alan
Journal For Healthcare Quality, 2015 - 37(2), pp. 117–125

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The frequency of diagnostic errors in outpatient care

"Our population-based estimate suggests that diagnostic errors affect at least 1 in 20 US adults. This foundational evidence should encourage policymakers, healthcare organisations and researchers to start measuring and reducing diagnostic errors."

The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations
H Singh, AND Meyer, EJ Thomas
BMJ Quality and Safety, 2014; 23: 727–731.

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Redirecting innovation in U.S. health care

"Our work for this project focused on identifying promising policy options to change which medical technologies are created in the first place, with these two related policy goals:

1. Reduce total health care spending with the smallest possible loss of health benefits.
2. Ensure that new medical products that increase spending are accompanied by health benefits that are worth the spending increases."

Redirecting innovation in U.S. health care: options to decrease spending and increase value
S Garber, SM Gates, EB Keeler, ME Vaiana, AW Mulcahy, C Lau, AL Kellermann
RAND Corporation
2014

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Improving dementia long-term care

"RAND identified 25 high-impact policy options covering five broad objectives to improve dementia long-term services and supports (LTSS) delivery system, workforce, and financing."

Improving dementia long-term care: a policy blueprint
RA Shih, TW Concannon, JL Liu, E Friedman
RAND corporation

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Accelerating improvement through systems engineering

"Systems engineering has often produced dramatically positive results in the small number of health-care organizations that have implemented such concepts. These efforts have transformed health care at a small scale, such as improving the efficiency of a hospital pharmacy, and at much larger scales, such as coordinating operations across an entire hospital system or across a community."

Better health care and lower costs: accelerating improvement through systems engineering
President’s Council of Advisors on Science and Technology

May 2014

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The UK healthcare system scores highest on quality, access and efficiency

"The United Kingdom ranks first overall, scoring highest on quality, access, and efficiency"

Mirror, mirror on the wall: how the performance of the U.S. health care system compares internationally
K Davis, K Stremikis, D Squires, C Schoen
The Commonwealth Fund
June 2014

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Report cards and outcome measurements to improve the safety of surgical care

"This review summarises the history of American College of Surgeons National Surgical Quality Improvement Project and its components, and describes the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety."

The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program
M Maggard-Gibbons
BMJ Quality and Safety, 2014; 23: 589-599

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Environmental sustainability in hospitals

"Hospitals and care systems increasingly are looking for ways to improve efficiency and reduce overall costs while also improving the overall patient experience. Sustainability initiatives offer significant environmental and financial benefits for organizations—benefits that will help hospitals and care systems thrive now and in the future."

Environmental sustainability in hospitals: the value of efficiency
Health Research & Educational Trust
May 2014

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Measuring quality at a system level

"Quality is being measured and reported across healthcare organizations and sectors, but efforts are rarely made to connect the activity in one organization to quality experienced by patients and clients in another part of the healthcare system. This article describes one regional health organization's journey to measuring health quality at a system level." 

Measuring quality at a system level: an impossible task? the Toronto Central LHIN experience
R Solomon, C Damba, S Bryant
Healthcare Quarterly, 2013, 16(4): 36-42

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Accountable care organisations: Testing, evaluating and learning what works

"Now more than ever the NHS needs to be able to innovate at scale and pace and testing out a variety of ways of integrating care should be encouraged."

Accountable care organisations in the United States and England: Testing, evaluating and learning what works
Stephen Shortell, Rachael Addicott, Nicola Walsh, Chris Ham
The King's Fund
March 2014

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