Medicare's Quality Improvement Organization Program Maximizing Potential (2006) / Chapter Skim
Currently Skimming:
Appendix C Approaches to Evaluation Design
Appendix C Approaches to Evaluation Design
Pages 466-472
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 466... ...
, refined definition of the "disease" (quality improvement) , and confounding factors (such as the voluntary nature of the program)
|
From page 467... ...
One would thus need to make sure that the cases and the controls match on variables that are related to improvements in quality, such as participation in other quality improvement efforts or willingness to participate. (This might mean that both cases and controls would have to be sampled from a population of providers who volunteered to work with QIOs.)
|
From page 468... ...
The more precise the definition of this exposure becomes, the less the risk involved in obtaining confounding variables that bias the results. Confounding factors have made it difficult to evaluate quality improvement interventions that are multifaceted and that take place in dynamic, complex systems types of environments.
|
From page 469... ...
Other limitations of confounding factors may be applicable, as may the factor of "readiness for change." The literature includes a growing number of examples of randomized controlled trials of quality improvement interventions. Kiefe and colleagues performed a successful randomized controlled trial of provider feedback among clinicians in Alabama (Kiefe et al., 2001)
|
From page 470... ...
470 APPENDIX C could be initiated with nursing homes in one region of the state that could act as the experimental group and nursing homes in another region that could act as the control group by not participating in the intervention. This might also be applied to the comparison of the results for a region in one state with the results for a region in another state.
|
From page 471... ...
A good example of the use of qualitative methods is the work of Bradley and colleagues in their study of the institutional factors that influenced hospitals' successful quality improvement efforts to promote the use of beta-blockers (Bradley et al., 2001)
|
From page 472... ...
1995. Methodologic guidelines for systematic reviews of randomized control trials in health care from the Potsdam consultation on meta-analysis.
|
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.