Measuring What Matters in Health: Lessons from the Veterans Health Administration State of the Art Conference

Asch, Steven M.; Kerr, Eve A.

doi:10.1007/s11606-015-3576-z

Cited by 6 publications

(9 citation statements)

References 10 publications

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“…Although many of these outcome variables are easily obtained from routinely collected administrative data, their use as quality metrics is complicated by challenging risk‐adjustment in a diverse medically complex patient population, the presence of unmeasured risk factors, and variable coding in administrative claims 15‐20 . Furthermore, results produced by these outcome measures often lack patient input and have limited ability to collect meaningful timely information that is capable of guiding quality improvement interventions 10‐14,18‐23 …”

Section: Introductionmentioning

confidence: 99%

Patient‐reported experience measures are essential to improving quality of care for chronic wounds: An international qualitative study

Squitieri

Tsangaris

Klassen

et al. 2020

International Wound Journal

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Traditional quality measures for chronic wounds have focused on objective outcomes that are challenging to risk adjust, lack patient input, and have limited ability to inform quality improvement interventions. Patient‐reported experience measures (PREMs) provide information from the patient perspective regarding health care quality and have potential to improve patient‐centredness, increase care efficiency, and generate actionable data for quality improvement. The purpose of this study was to understand patient experiences and health care processes that impact quality of care among patients with chronic wounds. Sixty patients at least 18 years of age with various wound aetiologies were recruited from Canada, Denmark, The Netherlands, and the United States as part of a larger phase 1 qualitative study to develop a patient‐reported outcome measure for chronic wounds (WOUND‐Q). All patients had a chronic wound for at least 3 months, were fluent in their native speaking language, and able to participate in a one‐on‐one semi‐structured interview. Interviews were digitally recorded and transcribed verbatim. Interpretive description was used to identify recurrent themes relating to patient experience and quality of care. We identified five domains (care coordination, establishing/obtaining care, information delivery, patient‐provider interaction, and treatment delivery) and 21 sub‐domains (access to patient information, interdisciplinary communication, encounter efficiency, provider availability, specialist referral, staff professionalism, travel/convenience, modality, reciprocity, understandability/consistency, accountability, continuity, credentials, rapport, appropriateness, complication management, continuity, environment/setting, equipment and supply needs, expectation, and patient‐centred) as potential opportunities to measure and improve quality of care in the chronic wound population. PREMs for chronic wounds represent an important opportunity to engage patients and longitudinally assess quality across clinical settings and providers. Future research should focus on developing PREMs to complement traditional objective and patient‐reported outcome measures for chronic wounds.

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Section: Introductionmentioning

confidence: 99%

Patient‐reported experience measures are essential to improving quality of care for chronic wounds: An international qualitative study

Squitieri

Tsangaris

Klassen

et al. 2020

International Wound Journal

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“…[3][4][5][6] However, information derived from demographic, administrative, and clinical data may fail to capture important changes in health status that can alter an individual's future patterns of care-seeking behavior. 7 The potential for PROMs to contribute to better patient identification has been inferred from prior studies showing that PROMs predict outcomes such as mortality, hospitalization, hospital readmission, and total health care costs. [8][9][10][11][12][13][14][15][16] Despite research showing that PROMs predict important outcomes, there is a lack of evidence that routinely collecting this information in non-research settings can also improve the ability of systems and providers to identify patients with higher health care needs.…”

Section: Introductionmentioning

confidence: 99%

Using a Self-Reported Global Health Measure to Identify Patients at High Risk for Future Healthcare Utilization

et al. 2017

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“…In both frameworks, the third phase, “going full-scale” 1 or “national roll-out effort”, 23 describes an effort that includes many organizations. Both frameworks present this final phase as a single phase, but both theory and evidence suggest that at the end of this phase some sites may be harder to engage.…”

Section: Introductionmentioning

confidence: 99%

Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives

et al. 2020

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Background Innovations and improvements in care delivery are often not spread across all settings that would benefit from their uptake. Scale-up and spread efforts are deliberate efforts to increase the impact of innovations successfully tested in pilot projects so as to benefit more people. The final stages of scale-up and spread initiatives must contend with reaching hard-to-engage sites. Objective To describe the process of scale-up and spread initiatives, with a focus on hard-to-engage sites and strategies to approach them. Design Qualitative content analysis of systematically identified literature and key informant interviews. Participants Leads from large magnitude scale-up and spread projects. Approach We conducted a systematic literature search on large magnitude scale-up and spread and interviews with eight project leads, who shared their perspectives on strategies to scale-up and spread clinical and administrative practices across healthcare systems, focusing on hard-to-engage sites. We synthesized these data using content analysis. Key Results Searches identified 1919 titles, of which 52 articles were included. Thirty-four discussed general scale-up and spread strategies, 11 described hard-to-engage sites, and 7 discussed strategies for hard-to-engage sites. These included publications were combined with interview findings to describe a fourth phase of the national scale-up and spread process, common challenges for spreading to hard-to-engage sites, and potential benefits of working with hard-to-engage sites, as well as useful strategies for working with hard-to-engage sites. Conclusions We identified scant published evidence that describes strategies for reaching hard-to-engage sites. The sparse data we identified aligned with key informant accounts. Future work could focus on better documentation of the later stages of spread efforts, including specific tailoring of approaches and strategies used with hard-to-engage sites. Spread efforts should include a “flexible, tailored approach” for this highly variable group, especially as implementation science is looking to expand its impact in routine care settings.

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Measuring What Matters in Health: Lessons from the Veterans Health Administration State of the Art Conference

Cited by 6 publications

References 10 publications

Patient‐reported experience measures are essential to improving quality of care for chronic wounds: An international qualitative study

Patient‐reported experience measures are essential to improving quality of care for chronic wounds: An international qualitative study

Using a Self-Reported Global Health Measure to Identify Patients at High Risk for Future Healthcare Utilization

Scaling Beyond Early Adopters: a Content Analysis of Literature and Key Informant Perspectives

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