Connections Between Quality Measurement and Improvement

Berwick, Donald M.; James, Brent C.; Coye, Molly Joel

doi:10.1097/00005650-200301001-00004

Cited by 423 publications

(393 citation statements)

References 9 publications

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“…Theoretical and empirical evidence supports the efficacy of physician audits and feedback in improving cancer screening. 29,[33][34][35][36][37] These findings are expected, given that NCQA-PCMH certification requires practices to use population management strategies to improve patient care.…”

Section: Discussionmentioning

confidence: 99%

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

et al. 2016

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BACKGROUND: Despite substantial resources devoted to cancer screening nationally, the availability of clinical practice-based systems to support screening guidelines is not known. OBJECTIVE: To characterize the prevalence and correlates of practice-based systems to support breast and cervical cancer screening, with a focus on the patientcentered medical home (PCMH). DESIGN: Web and mail survey of primary care providers conducted in 2014. The survey assessed provider (gender, training) and facility (size, specialty training, physician report of National Committee for Quality Assurance (NCQA) PCMH recognition, and practice affiliation) characteristics. A hierarchical multivariate analysis clustered by clinical practice was conducted to evaluate characteristics associated with the adoption of practice-based systems and technology to support guideline-adherent screening. PARTICIPANTS: Primary care physicians in family medicine, general internal medicine, and obstetrics and gynecology, and nurse practitioners or physician assistants from four clinical care networks affiliated with PROSPR (Population-based Research Optimizing Screening through Personalized Regimens) consortium research centers. MAIN MEASURES: The prevalence of routine breast cancer risk assessment, electronic health record (EHR) decision support, comparative performance reports, and panel reports of patients due for routine screening and follow-up. KEY RESULTS: There were 385 participants (57.6 % of eligible). Forty-seven percent (47.0 %) of providers reported NCQA recognition as a PCMH. Less than half reported EHR decision support for breast (48.8 %) or cervical cancer (46.2 %) screening. A minority received comparative performance reports for breast (26.2 %) or cervical (19.7 %) cancer screening, automated reports of patients overdue for breast (18.7 %) or cervical (16.4 %) cancer screening, or follow-up of abnormal breast (18.1 %) or cervical (17.6 %) cancer screening tests. In multivariate analysis, reported NCQA recognition as a PCMH was associated with greater use of comparative performance reports of guidelineadherent breast (OR 3.23,

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Section: Discussionmentioning

confidence: 99%

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

et al. 2016

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“…Examples include evaluating the impact of existing national or state health policies and programs on patient outcomes, access to care, and economic indicators. [1][2][3][4] Health services research has also helped identify new targets for national and state policy interventions, such as geographic variation in healthcare quality and cost, and health disparities in racial/ethnic minorities. 5,6 Health services researchers have paid less attention to research translation at the local level.…”

Section: Introductionmentioning

confidence: 99%

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study

O’Brien

Whitaker

2011

J GEN INTERN MED

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The community of health services researchers in general internal medicine has played an important role in affecting health policy at the national and state levels. Communitybased participatory research (CBPR) offers health services researchers an opportunity to identify and address health policy questions at the local level. We present the following four mechanisms by which CBPR might increase the ability of health services researchers to impact health by informing local policy. CBPR benefits community partners by allowing them to participate directly in the research process, gives academic researchers access to local data, enhances interpretation of research findings through an understanding of local context, and provides a natural infrastructure for affecting local policy through its community partners. For each of these mechanisms, we describe one example from a CBPR project conducted by one of us (M.O.). Considering the challenges and opportunities of conducting CBPR, future efforts will help describe how this emerging research paradigm can complement traditional health services research to most effectively inform health policy at multiple levels.KEY WORDS: community-based participatory research; health policy; Latino health; health services research; health disparities.

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“…Because human attention is bounded by cognitive and motivational limitations, tools that attract attention and increase salience of important criteria are helpful when trying to change human behaviour. But the evidence we have presented suggest that such private reporting is, as argued by Berwick et al (2003), insufficient feedback. It could be made more effective if it were to include information about how to improve performance and were followed by a goal-setting plan (Kluger and DeNisi, 1998).…”

Section: Altruism: the Problem Of Inadequate Feedbackmentioning

confidence: 64%

Models of governance of public services: empirical and behavioural analysis of ‘econs’ and ‘humans’

Bevan¹,

Fasolo²

2013

Behavioural Public Policy

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Connections Between Quality Measurement and Improvement

Cited by 423 publications

References 9 publications

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study

Models of governance of public services: empirical and behavioural analysis of ‘econs’ and ‘humans’

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