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Measuring Health Care: Using Quality Data for Operational, Financial, and Clinical Improvement



Measuring Health Care: Using Quality Data for Operational, Financial, and Clinical Improvement

Yosef D. Dlugacz

ISBN: 978-0-787-98383-3 September 2006 Jossey-Bass 240 Pages


This invaluable guide shows students and professionals how measurements and data can be used to balance quality services and financial viability and how measures can help to evaluate and improve organizational, clinical, and financial processes. The book explains the various performance measurement methods used in health care and shows their practical impact on clinical patient outcomes.

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Figures and Tables.


The Author.


1 Overview: What Measures Measure.

Measures and the Medical Staff.

Measures and Patients.

Measures and Health Care Leaders.

Measures and Money.

Measures and Evaluating Care.


Things to Think About.

2 Fundamentals of Data.

Quality and Finance: A Perfect Fit.

Quality and Accountability.

Let the Walls Come Tumbling Down.

Finding Answers.

Objectifying the Delivery of Care.

Case Example: Cardiac Mortality.

Case Example: Intensive Care Units.

Defining Goals.

Nothing New Under the Sun.

Case Example: Falls.

Communicating Information from Quality Measures.

Leadership Defines the Level of Quality.

Finding Questions.


Things to Think About.

3 Using Data to Improve Organizational Processes.

Satisfying the Demanding Consumer.

Offering Value.

Showing the Numbers.

Measures Are Good Business.

Managing with Measures.

The Value of Measures.

Measures and Organizational Processes.

Case Example: Nutrition.

Case Example: Housekeeping.

Monitoring Performance.

Measures Promote Knowledge.

Lack of Measures Leads to Poor Resource Management.

Measures and Evaluating Services.


Things to Think About.

4 What to Measure—and Why.

Leadership Determines What to Measure.

Measures Define Quality Care.

Measures Inform Financial Decisions.

Measures and Purchasing Decisions.

Measures and Patient Safety.

Quality Methodology for Performance Improvement.

Developing a Performance Improvement Plan.

Case Example: Plan Do Check Act for Bariatric Surgery.

Monitoring Variation from the Standard.

Case Example: Moving Between Levels of Care.

Understanding Patient Flow.


Things to Think About.

5 Promoting Accountability Through Measurements.

Measures and Organizational Goals.

Justifying Expenses.

Case Example: Self-Extubations.

Getting the Doctors on Board.

Case Example: Wrong-Site Surgery.

Analyzing Errors.

Changing the Culture.

Asking Questions.

Evaluating Information and Communicating Results.


Things to Think About.

6 The Rationale for External Drivers of Quality.

The Government Takes the Lead.

Monitoring Quality for Changed Practices.

The Media Carry the Message.

Public Pressure Forces Change.

Quality and Community Relations.

Truth or Consequences.

Quality Data Force Change.

Case Example: Coronary Artery Bypass Graft.

Make the Regulations Work for You.


Things to Think About.

7 Integrating Data for Operational Success.

Different Data Tell Different Stories About Care.

Working with Administrative Data.

Working with Primary Data.

Case Example: Stroke.

Operational Decisions and Quality Data.

Quality and Risk.

Case Example: FMEA and Blood Transfusions.

Communicating Quality Data.

Case Example: Decubiti.

Measures Tell the Truth.


Things to Think About.

8 Internal Drivers of Quality.

Using Guidelines to Drive Quality.

Ensuring That the Standard of Care Is Met.

CareMaps Promote Standardized Care.

Variance Data Help Drive Quality.

Dealing with Resistance to CareMaps.

Implementing Guidelines to Drive Quality Care.

Everyone Benefits from CareMaps.

Documenting the Delivery of Care.

Case Example: Detoxification Guidelines.


Things to Think About.

9 Using Data for Performance Improvement.

Aggregated Data Offer a Different Perspective.

Case Example: Using Quality Methods to Ensure Consistency of Care.

Case Example: Increasing Access to Care.

Case Example: Improving Sterilization Across the System.

Collaboration Works.


Things to Think About.




•       Audience Need: This book fulfills the need by graduate courses with an applied or professional focus for a strong book on health care management methods.

•       Platform: Yosef Dlugacz is rising in the health care quality field, with a heavy and increasing schedule of seminars and academic lectures. In recent years, his hospital, North Shore University Hospital in Manhasset, NY, was singled out in a study by the Harvard School of Public Health for the achievements of its quality management team, was named by US News and World Reports as having one of the top cardiovascular programs in the country,  and rated the number one metropolitan-area hospital in the country by AARP’s Modern Maturity magazine

•        Practical Approach: This book clearly links methods of measurement with outcomes in patient care, cost-effectiveness, and efficiency.

•       Breadth: In one concise volume, students and professionals can learn fundamentals of data use in health care, what to measure, promoting accountability through measurement, improving organizational processes through measurement, outside factors and drivers in the use of data, report cards -- what they are and how they work, internal factors and drivers in the use of data, and applying data for performance improvement.

•       Ready for Classroom: Will include an instructor's guide with case studies, exercises, chapter outlines, key points for instruction, and other features.