Evaluating Critical Care: Using Health Services Research to Improve Quality

Author:   William J. Sibbald ,  Julian F. Bion
Publisher:   Springer-Verlag New York Inc.
Volume:   35
ISBN:  

9780387953816


Pages:   379
Publication Date:   01 January 2002
Format:   Paperback
Availability:   In Print   Availability explained
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Evaluating Critical Care: Using Health Services Research to Improve Quality


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Overview

Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con­ sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2]. Donabedian [1] pro­ posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting of the restaurant, how close the tables are to each other, the extent of the wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi­ cal care. Processes are the actual treatments offered to patients. Finally, outcomes are what happens to patients, for example, mortality, quality of life, and satisfac­ tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.

Full Product Details

Author:   William J. Sibbald ,  Julian F. Bion
Publisher:   Springer-Verlag New York Inc.
Imprint:   Springer-Verlag New York Inc.
Volume:   35
Dimensions:   Width: 15.50cm , Height: 2.10cm , Length: 23.50cm
Weight:   0.605kg
ISBN:  

9780387953816


ISBN 10:   0387953817
Pages:   379
Publication Date:   01 January 2002
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Paperback
Publisher's Status:   Active
Availability:   In Print   Availability explained
This item will be ordered in for you from one of our suppliers. Upon receipt, we will promptly dispatch it out to you. For in store availability, please contact us.

Table of Contents

Overview.- - Critical Care: Problems, Boundaries and Outcomes.- Health Services Research: A Domain where Disciplines and Decision Makers Meet.- Methods of Measurement in Intensive Care.- The Structure of Intensive Care.- Process of Care Assessment and the Evaluation of Outcome from Intensive Care.- Severity of Illness.- Measuring Treatment Outcomes in Intensive Care: Mortality, Morbidity, and Organ Dysfunction.- Health-Related Quality of Life: During and Following Critical Care.- Quality of Life and Longer Term Outcomes.- Techniques for Acquiring Information.- Comparing ICU Populations: Background and Current Methods.- A Hospital-Wide System for Managing the Seriously Ill: A Model of Applied Health Systems Research.- Funding and Support.- Hypothesis Generation: Asking the Right Question, Getting the Correct Answer.- The Integration of Evidence Based Medicine and Health Services Research in the ICU.- Using Systematic Reviews to Inform Decision Makers.- Consensus Methods and Consumer Opinion.- Benchmarking in the ICU: The Measurement of Costs and Outcome to Analyze Efficiency and Efficacy.- Assessment of Medical Devices.- Health Informatics.- Databases, Registries and Networks.- Application and Interpretation: Using Data to Improve Outcomes.- Organizational Effects on Outcomes.- Geographical Differences in Outcomes.- Disaggregating Data: From Groups to Individuals.- Driving Improvements: Quality Management in the ICU.- Applied Health Services Research: Translating Evidence into Practice.- Translating the Evidence: Creating and Sustaining Change.

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