Outcomes management最新文献

This exploratory, cross-sectional, quantitative study investigated the relationship among hospital nurses' willingness to provide care for severe acute respiratory syndrome (SARS) patients, their attitudes toward SARS infection control measures, and nurses' health status and demographic characteristics. This project was conducted from May 6 to 12, 2003. A total of 126 nurses working in hospitals participated in this study. A conceptual model was developed, and the author designed a questionnaire to test this model. The developed model explained 32% of the variance in nurses' willingness to provide care for SARS patients. Nurses' levels of agreement with general SARS infection control measures, self-treatment of relief of fever and cough, necessity to close Hoping and Jenchi hospitals, nurses' physical health status, and holding a bachelor's degree were statistically significant predictors of nurses' willingness to care for SARS patients. Based on these findings, suggestions and study limitations are discussed.

It is essential that outcomes are evaluated and actions are taken to resolve problematic decision support issues. Many organizations are planning a transition to clinical information systems that will have data repositories and integrated databases within their systems. These transitions take years to complete, and systems must be put into place to collect data and report outcomes during the interim period. Careful and strategic planning is important so that the most effective use of existing technology and the most appropriate systems are implemented to manage outcomes. Multidisciplinary teams that use the most efficient technologic approaches will best meet the challenge to provide the most cost-effective care with the best quality outcomes.

Although adverse events are one gauge of hospital quality, determining the incidence and causes of adverse events is fraught with problems. This study tested a method to prospectively collect anonymous adverse events data using the Adverse Event Coupon. The results demonstrated the viability of the Adverse Event Coupon to collect adverse events data. Changes were made to the coupon based on feedback from registered nurses.

Outcomes for elderly patients after critical illness have been examined predominantly in terms of survival and selected aspects of functional status. The objectives of this study were to explore and compare the impact of intensive care unit treatment on health and functional status outcomes among 196 elderly and middle-age patients. Functional and health status outcomes did not differ in longitudinal assessments at 1, 3, 6, and 12 months after discharge from the intensive care unit. Severity of illness, not age, was the best predictor of physical functioning. Despite having more documented discharge planning, elderly patients reported concern about managing their care at home and knowing less about their medications, which have direct implications for care.

This study sought to determine if differences in quality of care existed between fee-for-service and health maintenance organization insurance plans (N = 154) for patients with congestive heart failure. There were no statistically significant differences in outcomes between the insurance plans.

Registered nurses (RNs) are one of many inputs that produce patient outcomes at some level of quality for a price. Optimal levels of any input are those that produce the most efficient outcome with relation to quality and cost. Through the use of optimization techniques, efficient staffing levels can be calculated to either minimize negative outcomes or maximize positive outcomes. Thus, the value of RNs can be established empirically and be precisely measured against other staffing inputs.

Accrediting organizations and payers are demanding valid and reliable data that demonstrate the value of services. Federal agencies, healthcare industry groups, and healthcare watchdog groups are increasing the demand for public access to outcomes data. A new and growing outcomes dynamic is the information requested by prospective patients in an increasingly consumer-oriented business. Patients demand outcomes, and resources are developing to meet these demands. Physicians are increasingly confronted with requests for information about their mortality and morbidity rates, malpractice suits, and disciplinary actions received. For example, in Virginia, prospective patients have access to data provided by the nonprofit group Virginia Health Information. After numerous resolutions by the Virginia Senate since 1999, the prospective Virginia medical consumer now has access to several annual publications: Virginia Hospitals: A Consumer's Guide, 1999 Annual Report and Strategic Plan Update, and the 1999 Industry Report: Virginia Hospitals and Nursing Facilities. Consumers have access to cardiac outcomes data stratified by hospital, gender, and cardiac service line (cardiac surgery, noninvasive cardiology, and invasive cardiology). This is particularly relevant to IHI because Virginia Health Information specifically targets cardiac care. IHI has a sizable investment in cardiovascular outcomes and has found outcomes measurement and research are key to providing quality care. IHI's goal is to move from an outcomes management model to a disease management model. The hope is to incorporate all aspects of the patient's continuum of care, from preoperative and diagnostic services through cardiac interventions to postoperative rehabilitation. Furthermore, every step along the way will be supported with functional status and quality of life assessments. Although these goals are ambitious and expensive, the return on investment is high.

The purpose of this pilot study was to evaluate the effectiveness of a self-awareness intervention in promoting increased awareness of body cues associated with various levels of glycemia and in enhancing well-being in persons with Type I diabetes and hypoglycemia unawareness. Study results indicated that participants could identify more cues of normal blood glucose; experienced fewer blood glucose levels below 3.5 mmol/L, fewer hypoglycemia unawareness-related events, and improved glycemia; but reported lower diabetes quality of life. The self-awareness intervention represents an innovative theory-based approach for helping clients with Type I diabetes and hypoglycemia unawareness to achieve positive health outcomes.

Nursing classification systems enable practitioners to describe their contributions to client care. The results of this study indicated an improvement in the outcome ratings, using the Omaha System, as a result of nursing interventions for 47 clients with chronic mental illness receiving services in three academic nurse-managed centers. The Omaha System was found to be a valid and reliable nursing documentation tool for outcome and quality of care measurement for clients with mental illness. This study describes how the Omaha System was used by undergraduate nursing students who were caring for adults with mental illness in nurse-managed centers.

Change is rapidly becoming an integral component of healthcare improvement. To implement change effectively, it is necessary to provide clear vision, leadership, and adequate time to develop followers. Coordination of activities and integration of changes in practice to promote positive outcomes are needed for success. This article analyzes the concept of change illustrated though a quality improvement intervention-based research project.