When you hear hoofs, think horses, not zebras: an evidence-based model of health care accountability.
Health care organizations are increasingly asked to show accountability about their performance. This paper proposes that accountability can best be achieved through evaluative methods that are based on evidence regarding the relationship between processes of care and expected outcomes. Root cause analysis (RCA) is used as an illustration of how a generic method of inquiring can be transformed into an ongoing monitoring, evaluation, user education and accountability strategy. The role of performance indicators, as well as patient and community expectations, is discussed.
Center for Performance Sciences, Elkridge, MD 21075, USA. vkazandjian@cpsciences.com
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Kazandjian
D015984:Causality; D019317:Evidence-Based Medicine; D006801:Humans; D008962:Models, Theoretical; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*