title: How can clinicians measure safety and quality in acute care?
abstract: The demand for high quality care is increasing and warranted. Evidence suggests that the quality of care in hospitals can be improved. The greatest opportunity to improve outcomes for patients over the next quarter century will probably come not from discovering new treatments but from learning how to deliver existing effective therapies. To improve, caregivers need to know what to do, how they are doing, and be able to improve the processes of care. The ability to monitor performance, though challenging in healthcare, is essential to improving quality of care. We present a practical method to assess and learn from routine practice. Methods to evaluate performance from industrial engineering can be broadly applied to efforts to improve the quality of healthcare. One method that may help to provide caregivers frequent feedback is time series data--ie, results are graphically correlated with time. Broad use of these tools might lead to the necessary improvements in quality of care.
authors.affiliation: Department of Anesthesiology/Critical Care Medicine, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA. ppronovo@jhmi.edu
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Thomas
authors.initials: T
authors.lastname: Nolan
authors.forename: Scott
authors.initials: S
authors.lastname: Zeger
authors.forename: Marlene
authors.initials: M
authors.lastname: Miller
authors.forename: Haya
authors.initials: H
authors.lastname: Rubin
mesh_terms: D003422:Critical Care; D004738:Engineering / Q000379:methods; D019538:Health Care Surveys; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007221:Industry / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration; D012308:Risk Management; D017751:Safety Management / Q000379:methods