Quality Programs in Neurosurgery: The Memorial Hermann/University of Texas Experience

摘要: The importance of outcome measures is steadily increasing due to the rise "pay for performance" and advent population health. In 2007, a quality initiative was started poor performance on rankings such as University Health Consortium (UHC) report card. Inherent all efforts are common challenges: how engage providers; gather ensure accuracy data; attribute results individuals; permanent improvements. After analysis, strategy developed that included an initial focus 3 metrics (mortality, infection rates, complications), leadership from practicing neurosurgeons, protocol development adherence, subspecialization. addition, it decided would initially apply attending physicians only, but entire team need be involved. Once fundamental elements were established, process could extended other providers. To support this effort, special information system tools formed. As program matured, measured outcomes improved more added (to current total 48). For example, UHC mortality ratios (observed over expected) decreased by 75%. Infection rates 80%. now involves trainee physicians, advanced practice providers, nurses, staff. This paper describes design, implementation, provides practical guide may useful groups undertaking similar initiatives.