COLLEGE OF HEALTH AND HUMAN SERVICES



COLLEGE OF HEALTH AND HUMAN SERVICESCalifornia State University, Long BeachHealth Care Administration DepartmentHCA 550-01 Continuous Quality Improvement in Health Care Services (3)Semester (Spring 2019)Instructor: Rus Billimoria, MD, MPH, CPHQE-mail: rus.billimoria@csulb.eduOffice Hours: By appointment only on day of the class or telephonically on any other mutually agreed upon day and time. Phone: (626) 943 6280Cell: (310) 508 1472Class Number: 8100Class Location: ET, Classroom # 0091/24/18 to 5/16/2018Class Meets: January 24 – May 10, 2019 Wednesdays from 7:00 PM to 9:45 PMAdditional Contact Information:HCA Program Administrative Coordinator: Deby McGill, deby.mcgill@csulb.eduTel. 562/985-5694; fax 562/985-5886Catalog Description550. Continuous Quality Improvement in Health Services (Units 3)Prerequisites: HCA 502Administrative and professional issues to assure quality in health care. Historical beginnings: metrics and indicators; state-of-the-art practices; voluntary and governmental monitoring. Letter grade only (A-F). (Lecture)Instruction Mode: In PersonCourse ObjectivesQuality health care has become a worldwide goal. Communities around the world are now increasingly involved with effectuating the value proposition in healthcare, and the science of health care quality is advancing rapidly. The current economic challenges caused by a worldwide recession have created ideal conditions for change”. The purpose of this course is to develop student’s evaluation and analytical skills with the concepts of Quality and the process of Quality Improvement across the Health Care continuum. This course uses as a background, the history and evolution of quality, its terms, principles, theories, and practices. The student is introduced to a diverse collection of methods of improving quality, including but not limited to continuous Quality Improvement and Total Quality Management, and to the guidelines for implementing quality management and the continuous quality improvement processes. Students will be familiarized with Six Sigma and other tools that are an integral component of Process Improvement and Customer Satisfaction. The value proposition is now an integral part of Quality Improvement and is discussed in detail. Additionally , the students will be asked to review the changes that a selected number of health care systems from across America have implemented in order to achieve the Institute of Medicine’s goals to make quality health care more safe, timely, effective, equitable, efficient, and patient-centered. Learning Objectives, Domain and Competency TableThe competencies are derived from job analysis surveys of healthcare executives across the healthcare continuum so that they are aligned with the challenges and work experienced by leaders today. Healthcare organizations use the competency tool to better define the requirements of specific roles within the organization. Targeted training and development plans are based on elements within the competency tool. This Quality Improvement course focuses on two major domains of Knowledge of the Healthcare Environment and Business Skills and Knowledge form the Competency Assessment Tool. In addition other domains secondarily also play a role for specific items presented in this course.The Competency Tool (5 Critical Domains):1. Communication and Relationship Management:Relationship ManagementCommunication SkillsFacilitation and Negotiation2. Leadership:Leadership SkillsOrganizational Climate and CultureCommunicating VisionManaging Change3. Professionalism:Personal and Professional AccountabilityProfessional development and Lifelong LearningContributions to Community and Profession4. Knowledge of Healthcare Environment:Healthcare Systems and OrganizationsHealthcare PersonnelThe patient’s PerspectiveThe Community and Environment5. Business Skills and knowledge:General ManagementFinancial ManagementHuman Resources ManagementOrganizational Dynamics and GovernanceStrategic Planning and marketingInformation ManagementRisk ManagementQuality ManagementPatient SafetyApplying the Competency Tool to this course:Learning ObjectiveDomainCompetencyActivity, Assignment or AssessmentUnderstand and evaluate the implications and effects of regulation, legislation and accreditation to Health Care Quality ImprovementKnowledge of the Healthcare Environment(4)Healthcare Systems and Organizations (A)Lecture, Short EssayAnd Class DiscussionUnderstand and discuss Quality, Efficiency, Return on Investment, Access to health care and Quality implicationsBusiness Skills and Knowledge (5)Quality Improvement (H)Lecture, Discussions, Project & PaperDiscuss, and Understand and Analyze Customer Satisfaction via Application of Quality Improvement Strategies, Philosophies, and TechniquesBusiness Skills and Knowledge (5)Quality Improvement (H)Lecture, Discussions, Project and Case studiesUnderstand, discuss Incentive Payments for Quality Health CareKnowledge of the Healthcare Environment(4)Healthcare Systems and Organizations (A)Lecture, Discussions, Paper or classroom projectsUnderstand, Discuss and Analyze implementation of Quality Improvement in Various Delivery SettingsKnowledge of the Healthcare Environment(4)Business Skills and Knowledge (5)Leadership (2)Healthcare Systems and Organizations (A)Quality (H)Managing Change (D)Lecture, Discussion, Project and Case studiesExpected Student Learning OutcomesOn completion of this course, the student will be able to:Describe the evolution of the health care systems and Quality Management/Improvement Programs up to the present and reflect on its future.Understand and Discuss the reasoning and the importance behind the requirements for Quality Management/Improvement Programs in the health care environment.Describe and Analyze the current state-of-the-art Quality Management/Improvement Program principles and techniques for health care in general. This includes the principles of Continuous Quality Improvement, Total Quality Management, and proactive versus reactive Quality Management programs.Understand and Evaluate the impact of federal and state legislation on Quality Management/Improvement Programs in Health care.Understand and analyze the need for and development of standards for accreditation of health care entities.Evaluate the recent impact of consumers on health care Quality Management/ Improvement Programs and the development of Report Cards for provider and managed care organizations (HEDIS etc.).Relative Resource Use- Analysis and Quality Improvement implicationsUnderstand the use of data and statistics for effective Quality Management/Improvement Programs. This includes the development and use of various Quality Improvement tools for process improvement and improving customer satisfaction.Understand basic elements of provider credentialing, risk management and liability issues as they relate to the Quality Management/Improvement Programs.Understand the effect of Patient Safety issues on Quality Management/Improvement systems and analyze the processes for improving overall safety within healthcare.Understand the recent trends in Quality Management/Improvement and Continuous Quality and Continuity of Care issues in Assisted Living, Skilled Nursing, and Long Term Care.Demonstrate understanding and analytics of the principles behind development of Quality Management/Improvement Programs and processes for a health care entity via successful completion of class project.Text(s) and other course materialsThis course does not prescribe a specific text, since no single text would cover the broad scope of this course. However, the following books and materials are strongly recommended for review:Lecture notes and handout materials The HealthCare Quality Book- Elizabeth Ransom, Maulik Joshi, David Nash and Scott Ransom, 3rd Edition 2013, Health Administration Press, Chicago Illinois; ISBN 978-1-56793-590-5.Supplementary Text: McLaughlin and Kaluzny’s Continuous Quality Improvement in Healthcare, Sollecito and Johnson, 4th Edition, Copyright 2013, Jones and Bartlett Publication, Massachusetts; ISBN 13: 978-0-7637-8154-5.Supplementary Text: Conducting Health Outcomes Research-Robert L.Kane, David M. Radosevich, 2011, Jones and Bartlett Learning, LLC, Sudbury, MA 101776.Supplementary Text: Quality Healthcare- Robert C. Lloyd, 2019, 2nd Edition, Jones and Bartlett Learning; ISBN 9781284023077.A list of References is presented at the end of the syllabus. Students are encouraged to use this reference material for enhancing the information discussed in class. In addition, generous use of these and other references may be made for class papers and project assignmentsTypes of Assignments, Basis for Assigning the Course Grade and Sequence of Assignments1) Short Essay PapersTo understand the latest trends in Quality Management/Improvement Program it is necessary to review articles related to health care quality from professional medical or health care journals. All class sessions incorporate discussions on the latest trends presented in these journal articles. Students will be expected to read and summarize selected articles or readings in the form of short papers on an assigned topic (a maximum of two, doubled spaced and typed pages). The topic will be assigned in class. Examples of Journals that may be the subject of your reviews are as follows:Journal of the American Medical Association (JAMA) - New England Journal of Medicine - Annals of Internal Medicine - Journal of Health Politics, Policy and Law - Health Affairs - Journal of HealthCare Quality - Med Bio World - Hospital & Healthcare Management Journals - The summaries should be well thought out. The following is a suggested format for your papers.Introduction – Reason for selecting the article(s) for the topic assigned.Ideas or thoughts presented by the article.Your analysis of the article and a critique/discussion.Conclusions that may be derived from the article.The short essay paper will be graded on a point scale worth up to 20% of the overall course score. Grading will be based on the following criteria based on the assigned topic:Selection of a journal article with current relevance to the topic for review.Clear presentation of the ideas and thoughts from the article.Your analysis of how the article corresponds to current issues and trends in Health Care Quality.Writing style.Two short essay papers will be due on the weeks assigned. Please see agenda on the following pages. The papers must be well presented. Submit one copy to the instructor. The copy will be returned to the student following review.2) CLASS PARTICIPATIONActive classroom participation is encouraged. Participation will include in classroom projects, Case Studies and presentations during sessions. Each student will have adequate opportunities to participate in classroom discussions and projects assigned. Level of participation will contribute towards the overall course grade.3) PROJECT: Quality Management/Improvement Program/Project Development A major classroom project will be the development of a Quality Management/Improvement Program or a Quality Improvement project for a health care entity, to be assigned the second week and presented during the fifth week of the course. Students will form teams and develop a Quality Improvement Program/Project for their assigned entity. The program development or project will make use of Quality Improvement principles, tools and strategies presented during the course. Fictitious scenarios/situations may be created for purposes of the project. Each student within a team will make specific contributions to the program development. The programs or projects developed will be presented to the class by all team representatives from each team. Please see course agenda below for timelines. Guest speakers may be present during presentations and will contribute to the discussions.Grading For “The Quality Management/Improvement Program Development Project":Team Presentation: Each Team member will orally present their project contributions during the team presentation. Short Paper: Each student’s contribution towards the team project will be presented in form of a combined team paper not less than two double-spaced type written pages. The paper shall comprise of the following elements:Introduction to the project. (20% of the total Project Grade)Presentation of the ideas and components the students are responsible for(40% of the Project Grade)Discussion on the importance of the students’ contributions towards the team project using the principles and theories discussed in class as well as pertinent literature reviewed by the student. (40% of the Project Grade)Include any literature support used.The Finals Grade will be a combination of the team paper and team presentation scores.Presentation Scoring Rubric will consider the following:All 7 Elements listed below must be covered in your PresentationOutline the research documenting need for healthcare improvement (Background)Define the system in which you are making improvements (Hospital, HMO,SNF or other entity)Identify key themes for improvement efforts (Which areas or items of the issue were selected for improvement and why)Use the improvement processes best suited for your project. (Six Sigma, Lean, PDSA etc)Develop and describe the team and team management skills used to accomplish your project. (Includes Team Dynamics)Describe basic steps used in managing change as you implemented your improvement planDescribe the value and context for the tools your team used and implemented in settings you used; examples:Fishbones/5 WhysPareto ChartsProcess mappingChecksheetsRun/control chartsFailure Mode and Effects Analysis (FMEA)SWATKaizen Event4) Position Paper (HCA 550): Position Paper Students may select their own topic related to Health Care Quality Improvement with presentation of information as highlighted in the example below:Example Only: Development of a Quality Management/Improvement Program or Project may present organizational and process problems or issues that need to be reviewed and resolved if possible. Develop your view of an idea or a problem related to the quality improvement program or project development using professional literature and other resources from within or without the course materials. This position paper must have four major components. Description of the problem or idea, Background. (20% of the Position Paper Grade)Literature Review. (30% of the Final Exam Grade)Your position, analysis/discussion and proposed solution if applicable. (40% of the Position Paper Grade)Literature support (APA Format) for your position and analysis. (10% of the Position Paper Grade)The position paper will need to be written on a minimum of 8-10 double spaced pages. Your position paper may be presented to the class. However oral presentations are optional. Arrangements for your presentation should be made at least a week prior to the desired presentation date. The oral class presentation of your position paper should be 15 minutes in length, followed by a question & answer session. Grading will be based mainly on the written paper, however, oral presentations may help enhance the overall final class grade. BASIS FOR ASSIGNING THE COURSE GRADEThis being a double numbered course, university policy requires greater expectations, additional work and different grading scales for graduate students. Due importance will be given to student participation in projects, papers, class work and exams. Letter Grades are assigned from A-F for level of achievement in the course. For final computation of the letter grades, following weights for each course component will be used:ComponentHCA 550Percent of GradeShort Essays:#25%Development of a Quality Management Program/ Project 35%Final Exam (Position Paper)30%Class Participation (Classroom Projects, Case Studies, Attendance)30%TOTAL100%AGENDA and SEQUENCE OF ASSIGNMENTS ( Subject to change)WeekObjective Week 1 – January 23, 2019Introduction to the course (Quality Kaleidoscope).Literature Review Guidelines.Introduction to Terminologies.Introduction to Health Care Systems.The evolution of Health Care Quality Management with a historic perspective.CQI Basic Elements1st Case Studies- Business Case For Quality Selection of Teams and Team Leaders for the project(s). Readings: Review Prescribed Text Book Chapters 1 and 2, Lecture Notes05270500Week 2 – January 30, 2019Continuous Quality Improvement- ThoughtsThe Kaizen approachDeming Approach1st Case Study Presentations by Teams (CS # 1)Suggested Readings and literature search discussions:Review: Prescribed Text Book Chapter 2, Lecture Notes-609609588500Week 3 – February 06, 2019 Juran, Crosby and FeigenbaumBeyond Ishikawa- Kano ModelAffinity Charts and Process Flow Diagrams2nd Case StudyReview: Chapters 3 (Prescribed Text Book), Lecture Notes05270500Week 4 – February 13, 2019Team Building and Effectiveness of CQI TeamsAnalyze Team Performance2nd Case Study Presentation. (CS # 2)Team updates on the Quality Improvement project development by each team during class. Topic Selection.Review: Prescribed Text Book Chapter 14 and Pages 274-276 & Lecture Notes-50809334500Week 5 – February 20, 2019Root Cause Analysis, Failure Modes Effects AnalysisPareto Charts1st Classroom Project- Basic Tools and Analysis/InstructionsReview: Text Book, Chapters, 4 and 11, Lecture NotesShort Essay 1- Topic Announced01206500Week 6- February 27, 2019Process Variations , Analyzing Variations1st Classroom Project Presentations (CP # 1)Review: Text Book, Chapter3, Lecture Notes11684011874500Week 7- March 6, 2019A QI Strategy Analysis -Plan Do Study ActMining For DataReview: Text Book, Chapters 4, 5, Lecture NotesSubmit Short Essay 101905000Week 8- March 13, 2019Principles and Tools for CQI- Part 13rd Case Study/Review with class teamsReview: Text Book, Chapter 9, Lecture Notes11684010350500Week 9- March 20, 2019Principles and Tools for CQI- Part 2Run ChartsAnalysis using Run Charts3rd Case Study Team Presentations. (CS # 3)Review: Text Book, Chapter 10, Lecture NotesShort Essay 2- Topic Announced508007683500Week 10- March 27, 2019Control ChartsDeveloping DashboardsTeam Presentations on Classroom Project- Using some CQI Tools (CP # 2)Review: Text Book, Chapter 6, 10, Lecture Notes5080013017500Week 11- April 1 – April 7, 2019SPRING BREAK254008064500Week 12- April 10, 2019Six SigmaLean StrategiesLean Sigma Applications- Examples (Guest Speaker)Review: Text Book, Chapter 4, Lecture NotesShort Essay 2- Submit Papers5080012065000Week 13- April 17, 2019Medical Errors and Safety- Leap FrogApplying CQI Strategies to SafetyReview: Text Book, Chapter 4, Lecture Notes-4572011303000-60960-9842500Week 14- April 24, 2019Compliance and Quality- GUEST LECTURETeams to review lecture and develop presentations on compliance and quality.Review: Lecture Notes254003873500Week 15- May 1, 2019AccreditationPay For PerformanceLeveraging Claims for Quality, Predictive ModelingAnalyze Compliance aspects of Quality Improvement- Team Presentations. (CP # 3)Review: Text Book, Chapter 19, Lecture Notes-17780013144500Week 16- May 8, 2019CQI and Empowerment of ConsumerA Final Review/Recap of the Course-13208015494000Week 17- May 15, 2019FINALS WEEKFINAL EXAM- Project PresentationsIndividual Contribution Papers to be submittedSubmission of Position Papers2032011747500SUMMARY CASE STUDIES and CLASSROOM PROJECTS:Case Study # 1 – Business case for Quality (Select from 5 Case Studies)Case Study # 2- Using Report Cards and Dashboards, Quality of Care through patient feedbackCase Study # 3- Improvement, Patient Safety, Dynamic Complexity in Patient CareClassroom Project # 1- Project Background, Process Flow DiagramClassroom Project # 2- More CQI ToolsClassroom Project # 3- Compliance and QualityFinals ProjectEvaluation of Case studies will be based on type of case study.Withdrawal policyWithdrawal after 2nd week and before final 3 weeks “permissible for serious and compelling reasons;” include statement of how you will interpret university policy.DropsIt is the responsibility of the student to file for a drop status if he or she desires. No drops will be signed by the instructor after the second week for the accelerated program.Attendance policyStudents are required to attend and to be prepared for each session by reading any assigned or referenced materials. Attendance is expected at each class session. However, if there are compelling circumstances, an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to date in the class material.AccomodationIt is the student’s responsibility to notify the instructor in advance of the need for accommodation of a university verified disability (PS 11-07, Course Syllabi and Standard Course Outlines).Students needing special consideration for class format and schedule due to religious observance or military obligations must notify the instructor in advance of those needs.Students who require additional time or other accommodation for assignments must secure verification/assistance from the CSULB Bob Murphy Access Center (BMAC) office located at the Student Success Center. The telephone number is (562) 985-5401. Accommodation is a process in which the student, BMAC, and instructor each play an important role. Students contact BMAC so that their eligibility and need for accommodation can be determined. BMAC identifies how much time is required for each exam. The student is responsible for discussing his/her need with the instructor and for making appropriate arrangements. Students who are eligible to receive accommodation should present an Accommodation Cover Letter and a BMAC Student/Teacher Testing Agreement Form to the instructor as early in the semester as possible, but no later than a week before the first test. (It takes one week to schedule taking an exam at the BMAC office.) The instructor welcomes the opportunity to implement the accommodations determined by BMAC. Please ask the instructor if you have any questions.Cheating and plagiarismThe following is excerpted from the California State University, Long Beach Policy Statement 85-19, dated December 13, 1985.It is the policy of the faculty and administration to deal effectively with the student who practices cheating or plagiarism. These acts are fundamentally destructive of the process of education and the confident evaluation of a student's mastery over a subject. A University maintains respect and functions successfully within the larger community when its reputation is built on honesty. By the same token, each student benefits in helping to maintain the integrity of the University. This policy, therefore, provides for a variety of faculty actions including those which may lead to the assignment of a failing grade for a course and for administrative actions which may lead to dismissal from the University. It is the intent to support the traditional values that students are on their honor to perform their academic duties in an ethical manner. GENERAL:The following definitions of cheating and plagiarism shall apply to all work submitted by a student. DEFINITION OF PLAGIARISM:Plagiarism is defined as the act of using the ideas or work of another person or persons as if they were ones own, without giving credit to the source. Such an act is not plagiarism if it is ascertained that the ideas were arrived at through independent reasoning or logic or where the thought or idea is common knowledge. Acknowledge of an original author or source must be made through appropriate references, i.e., quotation marks, footnotes, or commentary. Examples of plagiarism include, but are not limited to, the following: the submission of a work, either in part or in whole, completed by another; failure to give credit for ideas, statements, facts or conclusions with rightfully belong to another; in written work, failure to use quotation marks when quoting directly from another, whether it be a paragraph, a sentence, or even a part thereof; close and lengthy paraphrasing of another writing or paraphrasing should consult the instructor. Students are cautioned that, in conducting their research, they should prepare their notes by (a) either quoting material exactly (using quotation marks) at the time they take notes from a source; or (b) departing completely from the language used in the source, putting the material into their own words. In this way, when the material is used in the paper or project, the student can avoid plagiarism resulting from verbatim use of notes. Both quoted and paraphrased materials must be given proper citations.DEFINITION OF CHEATING:Cheating is defined as the act of obtaining or attempting to obtain or aiding another to obtain academic credit for work by the use of any dishonest, deceptive or fraudulent means. Examples of cheating during an examination would include, but not be limited to the following: copying, either in part or in wholes, from another test or examination; discussion of answers or ideas relating to the answers on an examination or test unless such discussion is specifically authorized by the instructor; giving or receiving copies of an exam without the permission of the instructor; using or displaying notes; "cheat sheets," or other information or devices inappropriate to the prescribed test conditions, as when the test of competence includes a test of unassisted recall of information, skill, or procedure; allowing someone other than the officially enrolled student to represent the same. Also included is plagiarism, which is defined as altering or interfering with the grading procedures. It is often appropriate for students to study together or to work in teams on projects. However, such students should be careful to avoid use of unauthorized assistance, and to avoid any implication of cheating, by such means as sitting apart from one another in examinations, presenting the work in a manner which clearly indicates the effort of each individual, or such other method as is appropriate to the particular course.ACADEMIC ACTION:One or more of the following academic actions are available and may be invoked by the faculty member who finds a student has been cheating or plagiarizing. Review -- no action. An oral reprimand with emphasis on counseling toward prevention of further occurrences; A requirement that the work be repeated; Assignment of a score of zero (0) for the specific demonstration of competence, resulting in the proportional reduction of final course grade; Assignment of a failing final grade; Referral to the Office of Judicial Affairs for possible probation, suspension, or expulsionIn addition students may refer to the following website for information. . Additional information resourcesStudents interested in acquiring more information on the university syllabus policy please go to the Faculty Center for Professional Development website at: . The faculty handbook can also be found online at the following link: INTERNET RESOURCES:America’s Health Insurance PlansAmerican College of Medical QualityAmerican Health Information Management AssociationAmerican Health Information Management Association Healthcare AssociationAmerican Society for Healthcare Risk ManagementAmerican Society For Healthcare Risk Management for Qualityassociation for quality Association for Healthcare QualityCalifornia Code of Regulations Department of Corporationscorp.California Medical AssociationJoint Commission on Accreditation of Healthcare Organizations Medicarecms.National Guideline ClearinghouseNational Library of Medicinenlm.National Network of Libraries of MedicineQuality Indicator ProjectCOURSE BIBLIOGRAPHYFor convenience, Course Bibliography is presented in two sections. Section 1 includes published articles over the past 4 years (2014-2018) that are most relevant to this course. Lectures include information from these readings. Section 2 includes older published literature that is currently relevant and includes many a classic writing that continues to be included in current teachings. For both sections, the references are organized alphabetically by last name of primary author.Students are encouyraged to review this literature.Section 1: 2014-2018Davies, S. et al, Impact of including Readmissions for qualifying events in the patient safety indicators; American Journal of Medical Quality 2015, Vol. 30(2) 114–118.Feldman, Joshua, et al; Measuring and Improving Cervical, Breast and Colorectal Cancer Screening rates in a multisite Urban Practice in Toronto Canada; BMJ Quality Improvement Reports 2017;6:u213991.w5531. doi:10.1136/bmjquality.u213991.w5531Frist, William H., Connected Health and rise Of the Patient-Consumer, Health Affairs, 33, no.2 (2014):191-193.Gallagher, Thomas H and Mazor Kathleen, M; Taking Complaints Seriously: using the patient safety lens, BMJ Qual Saf 2015; 24:352–355.Griffiths A, Leaver MP. Wisdom of patients: predicting the quality of care using aggregated patient feedback BMJ Qual Saf 2018; 27:110–118.Harder, B., Comarow, A., Hospital Quality Reporting by US News and World report: Why, How and What’s Ahead, JAMA May 19, 2015 Volume 313, Number 19; 1903-1904Hebert, Philip C, Disclosure after large scale events: Price of honesty? BMJ Qual Saf 2015; 24:293–294.Hero, J., Blendon, R., Zaslavsky, A., and Cambell, A.,Understanding What MakesAmericans Dissatisfied With Their Health Care System: An International Comparison, Health Affairs, March 2016 vol. 35 no. 3 502-509 Himmelstein ,David U., MD, Steffie Woolhandler, MD, MPH,Letter- Physician Payment Incentives to Improve Care Quality, JAMA January 15, 2014 Volume 311, Number 3, 304. Ivers NM, Barrett J. Using report cards and dashboards to drive quality improvement:lessons learnt and lessons still to learn BMJ Qual Saf 2018; 27:417–420James III, A. Everette,J D, Gellad Walid F., MD and Primack Brian A., MD, Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement JAMA January 15, 2014 Volume 311, Number 3.Meltze ,David O. and Chung,Jeanette W., The Population Value Of Quality Indicator Reporting: A Framework For Prioritizing Health Care Performance Measures, HEALTH AFFAIRS 33, NO. 1 (2014): 132–139.Oostrom Tamar et al; Outpatient Office Wait Times and Quality Of Care For Medicaid Patients; HEALTH AFFAIRS 36, NO. 5 (2017): 826–832Ouyang, Helen; The art of Discharge; JAMA May 26, 2015 Volume 313, Number 20, 2027-2028.Pincus Harold, Scholle, Sarah H., Spaeth-Rublee, Bridgitta., Hepner, Kimberly and Brown Jonathan. Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges, Health Affairs, June 2016 vol. 35 no. 6 1000-1008.Platonova, E and Shewchuk, R.; Patient Assessment of Primary Care physician Communication: Segmentation approach; International Journal of Health Care Quality Assurance, Vol 28, No. 4, 2015, 332-334.Portela, M.C., et al, How to study improvement interventions: A brief overview of study types; BMJ Qual Saf 2015;24:325–336.Presec Madeline, et al, Primary Health Care That Works: The Costa Rican Experience; HEALTH AFFAIRS, 36, NO. 3 (2017) 531-538.Roberts, Eric T., et al; High Price and Low Price Physician Practices Do Not Differ Significantly On Care Quality or Efficiency; HEALTH AFFAIRS 36, NO 5. (2017), 855-864Roland Martin, D.M., and Campbell Stephen, Ph.D. Successes and Failures of Pay for Performance in the United Kingdom, N Engl J Med (NEJM)370;20, May 15, 2014??Vol. 370 No. 20,1944-1949.Spath Patrice, Introduction to Quality Health Care Management, 2018, 3rd Edition, AUPHA, Health Administration Press, Chicago, Illinois.Spittal, J.M., et al; The PRONE score: An algorithm for predicting doctors’ risk of formal patient complaints using routinely collected administrative data; BMJ Qual Saf 2015;24:360–368.Studdert,D., Bismark, M., Mello, M., Singh, H., Spittal, M. Prevalence and Chractersitics of Physicians Prone to Malpractice Claims; N Engl J Med 2016;374:354-62.Tinmouth J. BMJ Qual Saf 2018; 27:4–6. doi:10.1136/bmjqs-2017-006782Westover Chad et al, Quality of Care in a Low-Income Consumer-Driven Health Plan: Assessment of Healthcare Effectiveness Data Information Set (HEDIS) Scores for Secondary Prevention Journal for Healthcare Quality, Volume 36, Issue 3, 28-34.Zuger, Abigail ; Hospital Ratings: A guide for the perplexed; JAMA May 19, 2015 Volume 313, Number 19, 1911-1912. Section 2: Pre 2014- Important and Currently Relevant References:Adams, Karen, Greiner, Ann C., Corrigan, Janet M., Committee on Crossing the Quality Chasm: Next Steps toward a New Health Care System, 2004, 176 pages.Aspden, Philip, Corrigan, Janet M., Wolcott, Julie, Erickson, Shari M., Editors, Committee on Data Standards for Patient Safety; Patient Safety: Achieving a New Standard for Care, 2004, 550 pagesAuerbach Andrew D., M.D., M.P.H., The Tension between Needing to Improve Care and Knowing How to Do It N Engl J Med, 357;6, August 9, 2007Benneyan J C, Statistical Process Control as a Tool for Research and Healthcare Improvement, Qual Saf Health Care 2003;12:458–464Berwick Donald, Continuous Improvement as an Ideal in Health Care 1989; New England Journal of Medicine, 320, 1, 53-56Berwick Donald, Payment by Capitation and the Quality of Care- Part 5 (1996) The New England Journal of Medicine, 335,16,1227-1231Blumenthal David, Quality of Care – What is it? – Part I, (1996) The New England Journal of Medicine, 335, 12, 891-894Blumenthal David, The Origins of Quality of Care Debate- Part 4 ( 1996) The New England Journal of Medicine, 335, 15, 1146-1149Brook Robert, McGlynn Elizabeth, Measuring Quality of Care – Part 2, (1996) The New England Journal of Medicine, 335, 13, 966-970Brown, RN, CPHQ, Janet A., The Healthcare Quality Handbook: A Professional Resource and Study Guide, 2004/2005 Edition (20th edition available after 7/31/05)Budetti, PP; 10 Years beyond the Health Security Act Failure: Subsequent Developments and Persistent Problems. 2004, JAMA; 292: 2000-2006Bush, GW, Ensuring Access to Health Care: The Bush Plan. JAMA, 2004; 292: 2010-2011Chassin Mark, Improving the Quality of Care- Part 3, (1996) The New England Journal of Medicine, 335, 14, 1060-1063Chassin Mark, Hannan Edward and DeBuono Barbara , Benefits and Hazards of Reporting Medical Outcomes Publicly ( 1996) The New England Journal of Medicine, 334,6, 394-398Couch James (Editor), Health Care Quality Management/Improvement Program for the 21st Century, 1991, American College of Physician Executives and American College of Medical Quality.Davies, H. O., Washington, A. Eugene, Health Care Report Cards: Implications for vulnerable patient groups and the organizations providing them care (2002), Journal of Health Politics, Policy and Law, Vol. 27, 379- 399Dlugacz, Yosef D., Alice Greenwood, Andrea Restifo; The Quality Handbook for Health Care Organizations: A Manager's Guide to Tools and Programs ISBN: 0787969214 Pub. Date: March 2004 Series: J-B AHA Press, #131Ellen Nolte and C Martin McKee, Measuring the health of nations: Updating an earlier analysis, Health Affairs, Volume 27, 58-71, 2008.Golub, Robert M, Beyond Mental Mediocrity, JAMA, 2006, 296, 1139-1140Graber, Mark I, et al, JAMA, September 26, 2012—Vol 308, No. 12, 1211-1212.Gruen, RL, Pearson, SD, Brennan, TA, Physicians-Citizens-Public Roles and Professional Obligations. JAMA, 2004; 291: 94-98Hagland, Mark, Transformative Quality, 2009, CRC Press, ISBN: 13: 978-1-4200-8492-4Health Employer Data Information Set –HEDIS 2005/2006, Published by NCQAHersh, W, Health Care Information Technology: Progress and Barriers. JAMA 2004; 292: 2273-2274Iezzoni Lisa, Assessing Quality Using Administrative Data, (1997) Annals of Internal Medicine , 127, 8 (Part 2), 666-674Iglehart , John K., Mission Versus Reality In Emergency Care, Health Affairs, 32, no.12 (2013):2066.Liberatore Matthew J., (2013) "Six Sigma in healthcare delivery", International Journal of Health Care Quality Assurance, Vol. 26 Issue: 7, pp.601 – 626.Lighter Donald, E., Advanced Performance Improvement in Health Care-Principles and Methods, 2011, Jones and Bartlett Publishers, ISBN: 13: 978-0-7637-6449-4Kerry, J., Ensuring Access to Health Care: The Kerry Plan. JAMA, 2004; 292: 2010-2011Landrum, Mary Beth et al, Is spending more always wasteful? The appropriateness of care and outcomes among colorectal cancer patients. Health Affairs, Volume 27, 159-168, 2008Leach, David C, Philibert, Ingrid, High Quality Learning for High Quality Health Care-Getting it Right, JAMA, 2006, 296: 1132-1134Mclaughlin Curtis and Kaluzny Arnold, Continuous Quality Improvement in Health Care, 3rd Edition, 2006, Aspen Publication (Replaced with 4th Edition, See Below under # 35) Neuhauser Duncan, Provost Lloyd, Bergman Bo,The Meaning of Variation to Healthcare Managers …… BMJ Qual Saf, 2011; 20(Suppl 1):i36-i40Papanicolas ,Irene, Cylus ,Jonathan and Smith Peter C., An Analysis Of Survey Data From Eleven Countries Finds That 'Satisfaction' With Health System Performance Means Many Things, Health Affairs, 32, no.4 (2013):734-742.Perlin, Jonathan B., Rapid Core Measure Improvement Through a “Business Case for Quality” Journal for Healthcare Quality, Mar/April 2012, Vol. 36, No. 2, pp. 50–61.Prevalence of Overweight and Obesity among US Children, Adolescents and Adults, 1999-2002. JAMA, 2004; 291 2847-2850.Robert Shauna R. et al, Addressing Social Determinants to Improve HealthCare Quality and Reduce Cost, Journal for Healthcare Quality, Vol. 34, No. 2, 2012 pp. 12–20.Quality First: Better Healthcare for All Americans, Advisory Commission on Consumer Protection and Quality in the Healthcare Industry (Call 800/732-8200 for your free copy)Ransom, Elizabeth, Joshi, Maulik, S., Nash, David, B., Ransom, Scott, B., The Healthcare Quality Handbook, Second Edition, 2008, ISBN: 978-1-56793-301-7Reschovsky, J, D., Hargraves, J. Lee., and Smith, A. F., Consumer beliefs and health plan performance: It’s not whether you are in an HMO but whether you think you are. ( 2002), Journal of Health Politics, Policy and Law, Vol 27, 353-377 Robinson, JC, Reinvention of Health Insurance in the Consumer Era. JAMA, 2004; 291: 1880-1886Robinson, J.C., Slouching towards value based health care. Health Affairs, Volume 27, 11-12, 2008.Solecito, William A and Johnson Julie, K, 2013, McLaughlin and Kaluzny’s Continuous Quality Improvement in Healthcare, 4th Edition, Copyright 2013, Jones and Bartlett Publication, Massachusetts; ISBN 13: 978-0-7637-8154-5.Spath Patrice, Introduction to Quality Health Care Management, 2013, 2nd Edition, AUPHA, Health Administration Press, Chicago, Illinois. ................
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