This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Silver, M. P. Articles by Bateman, K. A. Search for Related Content PubMed PubMed Citation Articles by Silver, M. P. Articles by Bateman, K. A. Social Bookmarking                         What's this?

Improving Health Care Systems Performance: A Human Factors Approach

Salt Lake City, UT, msilver{at}healthinsight.org

Michelle S. Geis, MHA

Salt Lake City, UT

Kim A. Bateman, MD

Salt Lake City, UT

Under contract from the Centers for Medicare & Medicaid Services (CMS), Medicare Quality Improvement Organizations (QIOs) promote improvement in health care system performance. With the QIO contract cycle that began in the fall of 1999, CMS adopted a broad national improvement agenda emphasizing 24 quality measures from 6 clinical topic areas. The Utah QIO developed a human factors and organizational safety management-based intervention strategy for the inpatient clinical topic areas, borrowing approaches and principles previously applied in hospital-based medication systems safety improvement efforts. Evaluation used measures and methods established by CMS to assess the adequacy of QIO performance nationwide. Comparison of statewide inpatient quality indicator performance rates in 1998 and 2000 showed absolute improvement on 15 of the 16 measures used. The average reduction in the failure rate for these clinical topic areas in Utah was 27.3%; this was the highest rate of improvement for any state in the nation. Utah's overall ranking on the combined inpatient clinical topic areas went from 16th at baseline to first at follow-up. The evaluation demonstrates exceptional levels of performance improvement in Utah hospitals when compared with national trends. It is, however, neither possible to uniquely isolate the effects of the QIO intervention from larger trends operating statewide, nor can the contributions of the various facets of the QIO intervention be disaggregated. The application of human factors and organizational safety management principles represents a promising strategy for accelerating the pace of improvement in health care.

Key Words: Health care quality improvement • human factors • quality improvement organizations

American Journal of Medical Quality, Vol. 19, No. 3, 93-102 (2004)
DOI: 10.1177/106286060401900302


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. Greenfield and J. Braithwaite Health sector accreditation research: a systematic review Int. J. Qual. Health Care, June 1, 2008; 20(3): 172 - 183. [Abstract] [Full Text] [PDF]

				C. Snyder and G. Anderson Do Quality Improvement Organizations Improve the Quality of Hospital Care for Medicare Beneficiaries? JAMA, June 15, 2005; 293(23): 2900 - 2907. [Abstract] [Full Text] [PDF]