title: Quality, clinical practice improvement, and the episode of care.
abstract: To improve routine clinical practice, we must measure patients treated in routine practice (effectiveness research), not in specially controlled circumstances (efficacy research). We describe a new study methodology, Clinical Practice Improvement (CPI), designed to develop data-driven, analytically-based protocols to achieve desirable outcomes at the lowest essential cost over the continuum of care. Measurement in CPI encompasses a comprehensive view of care management: patient characteristics, process steps, and outcomes. All three classes of data are considered simultaneously, providing a basis for meaningful analyses of significant associations between processes and outcomes. We present an example of a CPI pediatric asthma study.
authors.affiliation: Institute for Clinical Outcomes Research, Salt Lake City, Utah, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Horn
mesh_terms: D001249:Asthma / Q000191:economics / Q000628:therapy; D002675:Child, Preschool; D017281:Cost of Illness; D017050:Episode of Care; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D010346:Patient Care Management / Q000592:standards*; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014481:United States