Providing meaning to quality assessment work

Providing meaning to quality assessment work International Journal for Quality in Health Care, 2018, 30(5), 331 doi: 10.1093/intqhc/mzy131 Advance Access Publication Date: 30 May 2018 Editorial Editorial Measurement is key to being able to manage quality. Healthcare sys- about their care. This study therefore adds to the accumulating evi- tems have therefore developed measurement strategies to assess dence calling for more patient involvement and helps to identify con- structures, processes and outcomes, often with the important aim of crete improvement interventions for the hospitals of New South stimulating continuous improvement. Sometimes, however, meas- Wales (Australia). It may also inspire changes internationally. urement and assessment do not lead to quality improvement. This These two studies illustrate the potential of well-designed quality can happen when they are only used for judgement (for example for measurement activities, whether accreditation, patient surveys or licensing or financing decisions) or research (one cycle only ‘plan- other strategies, to add meaning to quality management work. In do-study-publish’). These activities are important, but enhanced these cases, the meaning was provided by showing the improved meaning comes only when measurement is used to lead to improve- clinical outcome or identifying clear improvement actions, but it ment. Activities such as accreditation and patient experience surveys may also be generated in many other ways. can provide meaning by leading to improvement. Falstie-Jensen et al. [1] have built on a previous study exploring the link between mortality and hospital accreditation [2]in References Denmark, extending their research to a second consecutive cycle of 1. Falstie-Jensen AM, Bogh SB, Johnsen SP. Consecutive cycles of hospital accreditation. They have separated hospitals with high compliance accreditation: persistent low compliance associated with higher mortality (awarded at least one full accreditation over the two cycles) and low and longer length of stay. Int J Qual Health Care 2018;30. 10.1093/ compliance (obtaining only partial accreditation across both cycles). intqhc/mzy037. They found that both 30-day mortality and length of stay were sig- 2. Falstie-Jensen AM, Larsson H, Hollnagel E et al. Compliance with hos- nificantly higher in low-compliance hospitals. These are important pital accreditation and patient mortality: a Danish nationwide findings that help to answer the question about whether accredit- population-based study. Int J Qual Health Care 2015;27:165–74. doi:10. ation is associated with improved clinical outcomes for patients. Of 1093/intqhc/mzv023. course, this study alone is not conclusive evidence, but it certainly 3. Harrison R, Walton M, Kelly P et al. Hospitalization from the patient adds a meaningful piece to the body of knowledge, suggesting that perspective: a data linkage study of adults in Australia. Int J Qual Health improvement is closely linked to accreditation work. Care 2018;30. 10.1093/intqhc/mzy024. In their survey of patient experience of hospital care in Australia, 1,2 ANTHONY STAINES Harrison et al. [3] managed to link data from experience and patient Institute for Education and Research on Social and Health admissions. This allowed them to show that unplanned admissions Organizations (IFROSS), University of Lyon 3, 18 Rue and adverse events were associated with poorer experience scores. Chevreul, 69007 Lyon, France, and As in many patient experience surveys, this study broadly showed Hospital Federation of Vaud, Bois de Cery, 1008 Prilly, very positive patient experiences. However, it also identified clear Switzerland improvement opportunities, showing that 14.4% of respondents Address reprint requests to: Anthony Staines, Hospital ‘felt that doctors spoke in front of them as if they were not there’ Federation of Vaud, Bois de Cery, 1008 Prilly, Switzerland. [3], 17.5% received conflicting information from different providers Tel: +41-21-643-73-53; E-mail: anthony.staines@bluewin.ch and 39.3% expressed the wish to be more involved in decisions © The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 331 Downloaded from https://academic.oup.com/intqhc/article-abstract/30/5/331/5025591 by Ed 'DeepDyve' Gillespie user on 20 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png International Journal for Quality in Health Care Oxford University Press

Providing meaning to quality assessment work

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Oxford University Press
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© The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
ISSN
1353-4505
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1464-3677
D.O.I.
10.1093/intqhc/mzy131
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Abstract

International Journal for Quality in Health Care, 2018, 30(5), 331 doi: 10.1093/intqhc/mzy131 Advance Access Publication Date: 30 May 2018 Editorial Editorial Measurement is key to being able to manage quality. Healthcare sys- about their care. This study therefore adds to the accumulating evi- tems have therefore developed measurement strategies to assess dence calling for more patient involvement and helps to identify con- structures, processes and outcomes, often with the important aim of crete improvement interventions for the hospitals of New South stimulating continuous improvement. Sometimes, however, meas- Wales (Australia). It may also inspire changes internationally. urement and assessment do not lead to quality improvement. This These two studies illustrate the potential of well-designed quality can happen when they are only used for judgement (for example for measurement activities, whether accreditation, patient surveys or licensing or financing decisions) or research (one cycle only ‘plan- other strategies, to add meaning to quality management work. In do-study-publish’). These activities are important, but enhanced these cases, the meaning was provided by showing the improved meaning comes only when measurement is used to lead to improve- clinical outcome or identifying clear improvement actions, but it ment. Activities such as accreditation and patient experience surveys may also be generated in many other ways. can provide meaning by leading to improvement. Falstie-Jensen et al. [1] have built on a previous study exploring the link between mortality and hospital accreditation [2]in References Denmark, extending their research to a second consecutive cycle of 1. Falstie-Jensen AM, Bogh SB, Johnsen SP. Consecutive cycles of hospital accreditation. They have separated hospitals with high compliance accreditation: persistent low compliance associated with higher mortality (awarded at least one full accreditation over the two cycles) and low and longer length of stay. Int J Qual Health Care 2018;30. 10.1093/ compliance (obtaining only partial accreditation across both cycles). intqhc/mzy037. They found that both 30-day mortality and length of stay were sig- 2. Falstie-Jensen AM, Larsson H, Hollnagel E et al. Compliance with hos- nificantly higher in low-compliance hospitals. These are important pital accreditation and patient mortality: a Danish nationwide findings that help to answer the question about whether accredit- population-based study. Int J Qual Health Care 2015;27:165–74. doi:10. ation is associated with improved clinical outcomes for patients. Of 1093/intqhc/mzv023. course, this study alone is not conclusive evidence, but it certainly 3. Harrison R, Walton M, Kelly P et al. Hospitalization from the patient adds a meaningful piece to the body of knowledge, suggesting that perspective: a data linkage study of adults in Australia. Int J Qual Health improvement is closely linked to accreditation work. Care 2018;30. 10.1093/intqhc/mzy024. In their survey of patient experience of hospital care in Australia, 1,2 ANTHONY STAINES Harrison et al. [3] managed to link data from experience and patient Institute for Education and Research on Social and Health admissions. This allowed them to show that unplanned admissions Organizations (IFROSS), University of Lyon 3, 18 Rue and adverse events were associated with poorer experience scores. Chevreul, 69007 Lyon, France, and As in many patient experience surveys, this study broadly showed Hospital Federation of Vaud, Bois de Cery, 1008 Prilly, very positive patient experiences. However, it also identified clear Switzerland improvement opportunities, showing that 14.4% of respondents Address reprint requests to: Anthony Staines, Hospital ‘felt that doctors spoke in front of them as if they were not there’ Federation of Vaud, Bois de Cery, 1008 Prilly, Switzerland. [3], 17.5% received conflicting information from different providers Tel: +41-21-643-73-53; E-mail: anthony.staines@bluewin.ch and 39.3% expressed the wish to be more involved in decisions © The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 331 Downloaded from https://academic.oup.com/intqhc/article-abstract/30/5/331/5025591 by Ed 'DeepDyve' Gillespie user on 20 June 2018

Journal

International Journal for Quality in Health CareOxford University Press

Published: May 30, 2018

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