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Evaluating Critical Care : Using Health Services Research to Improve Quality - William J. Sibbald

Evaluating Critical Care

Using Health Services Research to Improve Quality

By: William J. Sibbald (Editor), Julian F. Bion (Editor)

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Published: 21st January 2002
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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 ofthe restaurant, how close the tables are to each other, the extent ofthe 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.

From the contents: Critical care: problems, boundaries and outcomes
Health services research (HSR): a domain where disciplines and decision makers meet
The structure of intensive care
Process of care assessment and the evaluation of outcome from IC
Severity of illness
Measuring treatment outcomes in IC: mortality, morbidity, and organ dysfunction
Health-related quality of life: during and following critical care
Comparing ICU populations: background and current methods
A hospital-wide system for managing the seriously ill: a model of applied HSR
Funding and support
The integration of evidence-based medicine and HSR in the ICU
What are the results: 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
Registries and networks
Organizational effects on outcomes
Geographical variations in outcomes
Table of Contents provided by Publisher. All Rights Reserved.

ISBN: 9783540426066
ISBN-10: 354042606X
Series: Update in Intensive Care Medicine
Audience: General
Format: Paperback
Language: English
Number Of Pages: 379
Published: 21st January 2002
Publisher: Springer-Verlag Berlin and Heidelberg Gmbh & Co. Kg
Country of Publication: DE
Dimensions (cm): 22.86 x 15.24  x 1.91
Weight (kg): 0.59