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MEASURING ASPECTS OF ORGANIZATIONS PANEL

MEASURING ASPECTS OF ORGANIZATIONS PANEL. Jeff Alexander Ross Baker Paul Cleary Kelly Devers Shoshanna Sofaer Steve Shortell. AcademyHealth San Diego, CA June 7, 2004. Making change possible. CARE SYSTEM. Outcomes: Safe Effective Efficient Personalized Timely Equitable.

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MEASURING ASPECTS OF ORGANIZATIONS PANEL

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  1. MEASURING ASPECTS OF ORGANIZATIONS PANEL Jeff Alexander Ross Baker Paul Cleary Kelly Devers Shoshanna Sofaer Steve Shortell AcademyHealth San Diego, CA June 7, 2004

  2. Making change possible CARE SYSTEM • Outcomes: • Safe • Effective • Efficient • Personalized • Timely • Equitable Supportive payment and regulatory environment Organizations that facilitate the work of patient- centered teams High performing patient- centered teams • REDESIGN IMPERATIVES: SIX CHALLENGES • Redesigned care processes • Effective use of information technologies • Knowledge and skills management • Development of effective teams • Coordination of care across patient conditions, services, and settings over time. • Use of performance and outcome measurement for continuous quality improvement and accountability Source: Institute of Medicine, Crossing the Quality Chasm, p. 127, 2001.

  3. Source: Adopted from Ferlie, W.B. and S.M. Shortell (2001). “Improving Quality of Health Care in the United Kingdom and the United States: A Framework for Change.”The Milbank Quarterly 79(2).

  4. SOME ISSUES AND CHALLENGES • Capturing complexity • Multi-level measurement issues • Aggregation issues • Unit of analysis issues • Measuring change

  5. IMPORTANCE OF A “SYSTEM” APPROACH TO MEASUREMENT “Healthcare systems, as they manifest in the everyday workplace of hospitals, and physician offices, are felt to represent ‘complex adaptive’ rather than ‘mechanical’ systems…one in which the parts have potential to respond differently and unpredictably at a given point in time.

  6. IMPORTANCE OF A “SYSTEM” APPROACH TO MEASUREMENT (Cont.) These system parts can also move each other to act in specific ways. Most empirical studies (of medical errors)…did not take a systems approach. Rather they examined single variables such as teams or leadership without considering a larger, more inter-connected web of organizational dynamics in their analysis.” Source: T. Hoft et al. “Organizational Factors, Medical Errors, and Patient Safety,” Medical Care Research and Review, March, 2004:22-23.

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