RESUMEN
Realizing the importance of linking nursing's contribution to quality patient care, a pilot study was conducted to determine whether data regarding the quality indicators proposed by the American Nurses' Association (ANA) could be collected from five acute-care inpatient units at one medical center that is part of a multisite managed care system. Although it was determined that data regarding the ANA quality indicators could be collected at the study site, a variety of unanticipated findings emerged. These findings reflect both discrepancies and congruities between how the investigative team expected the ANA indicators to operate versus what was actually experienced. The lessons learned while collecting ANA indicator data are shared to assist future users and to advance the evolution of the ANA indicators.
Asunto(s)
American Nurses' Association , Recolección de Datos/métodos , Investigación en Administración de Enfermería/métodos , Atención de Enfermería/normas , Indicadores de Calidad de la Atención de Salud/estadística & datos numéricos , Infección Hospitalaria/prevención & control , Recolección de Datos/normas , Humanos , Tiempo de Internación , Programas Controlados de Atención en Salud/normas , Investigación en Administración de Enfermería/normas , Personal de Enfermería en Hospital/provisión & distribución , Evaluación de Procesos y Resultados en Atención de Salud/organización & administración , Satisfacción del Paciente , Proyectos Piloto , Carga de TrabajoRESUMEN
PURPOSE: To provide a framework for classifying outcome indicators for a more comprehensive view of outcomes and quality. METHODS: Review of outcomes literature published since 1974 from medicine, nursing, and health services research to identify indicators. Outcome indicators were clustered inductively. FINDINGS: Three groups of outcome indicators were identified: patient-focused, provider-focused, and organization-focused. Although investigators tend to focus on a select few outcome indicators, such as patient satisfaction, quality of life, and mortality, many indicators exist to measure outcomes. CONCLUSIONS: Selecting and integrating a wide array of outcome indicators from the various categories will provide a more balanced view of health care delivery as compared with focusing on a few common indicators or only one category.
Asunto(s)
Evaluación de Resultado en la Atención de Salud/clasificación , Indicadores de Calidad de la Atención de Salud/clasificación , Grupos Diagnósticos Relacionados/clasificación , Eficiencia Organizacional , Salud Holística , Humanos , Mortalidad , Objetivos Organizacionales , Satisfacción del Paciente , Atención Dirigida al Paciente/organización & administración , Calidad de Vida , Reproducibilidad de los ResultadosRESUMEN
Clinical case management is a system that has the potential to improve the efficiency and effectiveness of health care delivery. Given this potential, the Army Medical Department (AMEDD) is examining this process as a means to achieve goals of quality care and cost effectiveness. In this article, the authors describe the concept of case management, the AMEDD system of clinical case management, the implementation of clinical case management in the AMEDD, and the role of the case manager.