Continuous quality improvement and health promotion: can CQI lead to better outcomes?

Kahan, Barbara

doi:10.1093/heapro/14.1.83

Cited by 41 publications

(37 citation statements)

References 9 publications

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“…1,2 Patients' choice of site for care for perceived urgent health problems is likely to involve a multitude of factors and may, in turn, infl uence health care system organization and continuity of care. Canada, as have many other countries, has faced a shortage of family physicians for many years.…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Howard¹,

Goertzen²,

Hutchison³

et al. 2007

The Annals of Family Medicine

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PURPOSE Patient satisfaction is an important health care outcome. This study compared patients' satisfaction with care received for an urgent health problem from their family physician, at an after-hours clinic in which their physician participated, at a walk-in clinic, at the emergency department, from telephone health advisory services, or from more than 1 of those services. METHODSWe mailed a questionnaire to a random sample of patients from 36 family practices in Thunder Bay, Ontario. We elicited satisfaction with care for the most recent urgent health problem in the past 6 months on a 7-point scale (very dissatisfi ed to very satisfi ed). RESULTSThe response rate was 62.3% (5,884 of 9,397). Of the 5,722 eligible patients 1,342 (23.4%) reported an urgent health problem, and data were available for both services used and satisfaction for 1,227 patients. After adjusting for sociodemographic characteristics and self-reported health status, satisfaction with care received for most recent urgent health problem was signifi cantly higher among patients who visited or spoke to their family physician (mean 6.1; 95% confi dence interval [CI], 5.8-6.4) compared with all other services (all P <.004, adjusted for multiple comparisons), with the exception of patients who used the after-hours clinic affi liated with their physician, whose satisfaction was not significantly different (mean 5.6; 95% CI, 5.2-6.0). CONCLUSIONS Satisfaction was highest for patients receiving care from their own family physician or their physician's after-hours clinic. These results are important for new primary care models that emphasize continuity and after-hours availability of family physicians. 2007;5:419-424. 10.1370/afm.704 INTRODUCTION P atient satisfaction is an important outcome of health care services and can affect compliance with medical advice, service utilization, and the clinician-patient relationship. Ann Fam Med1,2 Patients' choice of site for care for perceived urgent health problems is likely to involve a multitude of factors and may, in turn, infl uence health care system organization and continuity of care. Canada, as have many other countries, has faced a shortage of family physicians for many years. For patients with a family physician, options for addressing acute health problems may include an urgent appointment with their own family physician, an after-hours clinic, a walk-in clinic, a hospital emergency department, or telephone health advisory services. Emergency department costs for minor acute illnesses are much higher than treatment in primary care settings, 3 and there are concerns about lack of continuity and duplication of services in walk-in clinics. 4,5 Patients' use of health services other than their family physician's practice is not entirely explained by the urgency of the Michelle Howard, MSc 420 URGENT HE A LT H C A R E S AT ISFAC T IONproblem or by availability of their family physician. For example, up to 30% of emergency department visits have been characterized as inappropriate or not urg...

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Section: Introductionmentioning

confidence: 99%

Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Howard¹,

Goertzen²,

Hutchison³

et al. 2007

The Annals of Family Medicine

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“…In addition, the availability of indicators that accurately reflect performance continues to be one of the greatest constraining factors to CQI in public health settings, as many have already pointed out, and one that sets it apart from healthcare (Kahan and Goodstadt 1999; Scutchfield et al 2009; Weir et al 2009). Public health unit informants were adamant that performance targets indicated by population health outcomes, which are subject to numerous determinants outside of their control, were problematic.…”

Section: Discussionmentioning

confidence: 99%

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

Price

Schwartz

Cohen

et al. 2017

hcpol

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Context: Evidence of the effect of continuous quality improvement (CQI) in public health and valid tools to judge that such effects are not fully formed. Objective: The objective was to adapt and apply Shortell et al.' s (1998) four dimensions of CQI in an examination of a public health accountability and performance management initiative in Ontario, Canada. Methods: In total, 24 semi-structured, in-depth interviews were conducted with informants from public health units and the Ministry of Health and Long-Term Care. A web survey of public health managers in the province was also carried out. Results: A mix of facilitators and barriers was identified. Leadership and organizational cultures, conducive to CQI success were evident. However, limitations in performance measurement and managerial discretion were key barriers. Conclusion:The four dimensions of CQI provided insight into both facilitators and barriers of CQI adoption in public health. Future research should compare the outcomes of public health CQI initiatives to the framework' s stated facilitators and barriers.

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“…While there is agreement from an industry point-of-view that quality embodies notions of efficiency, effectiveness, and consumer satisfaction, the fact remains that in healthcare, definitions of quality can be subjective [7,8]. According to the Institute of Medicine [9], quality healthcare should be: 1. safe, 2. effective, 3. patient-centered, 4. timely, 5. efficient, and 6. equitable.…”

Section: Quality Improvement In Healthcarementioning

confidence: 99%

Continuous Quality Improvement in Orthopaedic Surgery: Improving Patient Experience, Safety and Outcomes

Gartke

Roffey

Dobransky

et al. 2017

UOJM

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P a g e 4 9 | U O J M V o l u m e 7 I s s u e 1 | M a y 2 0 1 7 En réponse à la demande croissante de transparence et de responsabilité concernant les services de santé dispendieux, les fournisseurs de soins de santé ont mis sur pied des programmes d'amélioration continue de la qualité (ACQ) pour optimiser les soins et l'efficience. Les programmes d'ACQ qui évaluent rigoureusement les services de santé permettent des décisions plus éclairées quant aux améliorations à apporter, grâce au transfert de connaissances. Parmi les résultats positifs de ces programmes, on peut compter une plus grande satisfaction et une amélioration des résultats rapportés par les patients, des plans d'intervention particulièrement efficients, et une réduction des coûts. De nombreuses étapes dans la mise en place des programmes d'ACQ nécessitent une collaboration entre les médecins, le personnel de soutien, les gestionnaires de l'hôpital et les autres professionnels de la santé afin d'atteindre les objectifs désirés. La Division de chirurgie orthopédique de l'Hôpital d'Ottawa a lancé un programme d'ACQ conçu selon le modèle classique Donabedian, qui poursuit un triple objectif : 1. améliorer les soins, 2. améliorer l'expérience des patients, et 3. minimiser les coûts. La création d'une base de données électronique pour l'ACQ sera une composante clé du plan stratégique de 5 ans (2015-2020) de la Division, et se conforme à l'objectif de l'Hôpital d'Ottawa de devenir l'un des plus performants en Amérique du Nord, sur le plan de la qualité et de la sécurité des soins aux patients. Le but de cet article est de décrire brièvement le développement de nombreuses facettes de notre programme d'ACQ, et notre conformité aux normes de la qualité.

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Continuous quality improvement and health promotion: can CQI lead to better outcomes?

Cited by 41 publications

References 9 publications

Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Patient Satisfaction With Care for Urgent Health Problems: A Survey of Family Practice Patients

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

Continuous Quality Improvement in Orthopaedic Surgery: Improving Patient Experience, Safety and Outcomes

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