ABSTRACT
This article describes a collaborative effort between a major health care purchaser, three area health maintenance organizations, and a state Medicaid agency to develop clinical indicators as the basis for a comparison database. Some of the difficulties in developing a "common yardstick" of quality and value are candidly discussed.
Subject(s)
Health Benefit Plans, Employee/standards , Health Maintenance Organizations/standards , Outcome and Process Assessment, Health Care/organization & administration , Data Collection , Diagnosis-Related Groups , Forecasting , Health Benefit Plans, Employee/organization & administration , Health Care Coalitions , Health Maintenance Organizations/organization & administration , Massachusetts , Medicaid/organization & administration , Outcome and Process Assessment, Health Care/standards , Quality of Health Care/trends , United StatesABSTRACT
This strategic plan translates the HCHP vision statement into a working plan for one major clinical condition--asthma in children. It is a working plan for clinicians and managers across specialties and levels. The results of the projects will improve in a measurable way significant clinical practice and outcomes, in keeping with the FY 1993 strategic goals.
Subject(s)
Asthma/therapy , Child Health Services/standards , Health Maintenance Organizations/standards , Total Quality Management/organization & administration , Child , Child Health Services/organization & administration , Data Collection , Health Knowledge, Attitudes, Practice , Health Maintenance Organizations/organization & administration , Hospitalization , Humans , Massachusetts , Patient Education as Topic/standards , Patient Education as Topic/statistics & numerical data , Planning TechniquesABSTRACT
Much has been written about the strengths and weaknesses of quality assurance (QA) and continuous quality improvement (CQI) as approaches to achieving optimal quality and value in health care. In the past, the motivation behind QA was largely regulatory. Today, the driving force for CQI is corporate America, whose clout has key provider constituencies ready to cooperate as never before. This article argues that many of the functions of traditional QA will remain an integral component of quality management strategies for health care organizations and that the success of these efforts will depend on a coordinated effort by professionals from QA, quality management, and health services research. Furthermore, quality engineering concepts from other industries provide a useful framework to enable coordination among these three fields.
