Moving from "Small Qa" to "Large Qa"

Williamson, John; Moore, Donald E.; Sanazaro, Paul J.

doi:10.1177/016327879101400202

Eval Health Prof

1991

DOI: 10.1177/016327879101400202

|View full text |Cite

Moving from "Small Qa" to "Large Qa"

John Williamson¹,

Donald E. Moore

Paul J. Sanazaro

Abstract: In this article we describe an "outcomes framework" for planning and analyzing quality management systems in relation to their ultimate purpose, enhancing the wide range of health care benefits. "Small qa" includes those methods that focus on structure or process and induce improvement of outcomes. These methods are essential but, predictably, often involve minimal improvement of health care. "LARGE QA" is defined as those methods that focus on unacceptable outcomes and deduce processes and structures to be ch… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

1992

2006

Publication Types

Select...

Article5

Relationship

Self Cite1

Independent4

Authors

Journals

Cited by 5 publications

(1 citation statement)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our quest focused on confirming and explaining why remarkable government-funded work in noteworthy institutions did not lead to wider acceptance of ABNA as a gold-standard among methods. Williamson Williamson (1978c) and Williamson et al, 1978), and his project team results were surprisingly sparse, including a small number of circa 1980 s noncritical papers acknowledging or suggesting application of Williamson's methods in various American settings (Anderson and Shields, 1982;Palmer and Nesson, 1982;Ostrow and Kuntavanish, 1983;Payne et al, 1984;Donabedian, 1985;Fauman, 1989;Hillman, 1991), others linking ABNA to The Netherlands (Williamson, et al, 1985(Williamson, et al, , 1988(Williamson, et al, , 1993Casparie, 1995) where it seemed to have the greatest acceptance, other technical papers by Williamson and his affiliates, and one paper published under the heading "Heroes & Martyrs of Quality and Safety" that describes an unusual embargo imposed immediately after completion of Williamson's Medical Practice Information Demonstration Project (Neuhauser, 2002).…”

mentioning

confidence: 99%

Williamson's ABNA revisited

Birnbaum¹,

Konieczna²,

Ratner

2006

Clinical Governance: An Intl J

View full text Add to dashboard Cite

Purpose -The purpose of this viewpoint article is to acquaint those engaged in health care quality improvement and patient safety programs with an effective, well-documented but overlooked method. As described in a 1978 article, "Achievable Benefit Not Achieved" (ABNA) is a formal, efficient, transdisciplinary, evidence-based method to identify and prioritize quality improvement project topics. Design/methodology/approach -Narrative review of personal experience and pertinent literature. Findings -While the ABNA method succeeds in serving its purpose when applied, and no evidence could be found to discredit it, ABNA appears to have been abandoned and forgotten for reasons of political expediency. Research limitations/implications -A strength and weakness of this research is its reliance upon personal narratives from the limited number of individuals still available who have first-hand knowledge of past events. Convergence of those narratives along common themes, and their consistency with published records, is reassuring; however, age, memory, and some reluctance to broach political barriers limit one's ability to examine key events of past decades. A structured interview format conducted by a trained and experienced interviewer who had no vested interests in the topic, plus independent analysis of transcripts by researchers who have experience in qualitative methods, protects internal validity of the work. Practical implications -Today's emphasis on continuously improving the quality and safety of health care requires appropriately focused, effective programs. ABNA arose and was suppressed in an era when health service deficiencies characteristically remained hidden as potential embarrassments rather than sought out as opportunities for improvement. ABNA, that era's under-appreciated tool, should be reconsidered for its unique merits to guide today's programs. Originality/value -This work, one of the first efforts to trace the entire history of ABNA, confirms that the method remains practical, effective and has not been discredited.

show abstract

mentioning

confidence: 99%

Williamson's ABNA revisited

Birnbaum¹,

Konieczna²,

Ratner

2006

Clinical Governance: An Intl J

View full text Add to dashboard Cite

show abstract

Iatrogenic Complications in High-Risk, Elderly Patients

Lefèvre

Feinglass

Potts³

et al. 1992

Arch Intern Med

View full text Add to dashboard Cite

show abstract

Needs assessment in the new health care environment: Combining discrepancy analysis and outcomes to create more effective CME

Moore

1998

Journal of Continuing Education in the Health Professions

Self Cite

View full text Add to dashboard Cite

Abstract:The difference between what continuing medical education (CME) research suggests results in successful CME and how CME is actually planned has major implications for individuals who plan and conduct CME. There Key Words: Continuing medical education (CME), discrepancy analysis, effective CME outcomes, needs assessment Most physicians and others involved in health care regard continuing medical education (CME) as an important way for physicians to update the knowledge and skills necessary for providing the best possible health care to their patients. At the same time, concerns emerged several years ago that CME as it has been traditionally offered does not work.' Two important studies provide reassurance that CME does work but at the same time demonstrate that there are important planning considerations that are associated with CME activities that work. According to these studies, welldone needs assessment is an essential part of effective CME planning.In the first study, Fox et a1.2 interviewed 340 physicians about the learning activities they used in professional and personal change events and determined that the most successful change efforts focused educational activities on the behavior to be changed. Typically, physicians in the study changed a behavior by realizing that there was some difference between how they were performing that behavior and how they should have been performing that behavior. In educational circles, the identification and description of this difference between current performance and some desired performance, the discrepancy between "what is" and "what should be," is the definition of educational need.3-5In the second study, Davis et a1.6 reviewed 99 randomized controlled trials in which CME was positively associated with physician behavior change. They determined that successful CME results from planning that includes a focused needs assessment and multiple educational activities focused on the educational need identified by needs assessment.The vision of successful CME that emerges from these two studies is not necessarily the 133

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Moving from "Small Qa" to "Large Qa"

Cited by 5 publications

References 9 publications

Williamson's ABNA revisited

Williamson's ABNA revisited

Iatrogenic Complications in High-Risk, Elderly Patients

Needs assessment in the new health care environment: Combining discrepancy analysis and outcomes to create more effective CME

Contact Info

Product

Resources

About