Healthcare Quality Improvement Analytics: An Example Using Computerized Provider Order Entry

Abstract

Evaluation of sustainability after quality improvement (QI) projects in healthcare settings is an essential part of monitoring and future QI planning. With limitations in adopting quasi-experimental study design in real-world practice, healthcare professionals find it challenging to present the sustained effect of QI changes effectively. To provide quantitative methodological approaches for demonstrating the sustainability of QI projects for healthcare professionals, we conducted data analyses based on a QI project to improve the computerized provider order entry system to reduce patients’ dosing frequencies in Korea. Data were collected for 5 years: 24-month pre-intervention, 12-month intervention, and 24-month post-intervention. Then, analytic approaches including control chart, Analysis of Variance (ANOVA), and segmented regression were performed. The control chart intuitively displayed how the outcomes changed over the entire period, and ANOVA was used to test whether the outcomes differed between groups. Last, segmented regression analysis was conducted to evaluate longitudinal effects of interventions over time. We found that the impact of QI projects in healthcare settings should be initiated following the Plan–Do–Study–Act cycle and evaluated long-term effects while widening the scope of QI evaluation with sustainability. This study can serve as a guide for healthcare professionals to use a number of statistical methodologies in their QI evaluations.

A Crisis in the Health System and Quality of Healthcare in Economically Developed Countries

“…One of the definitions of the quality of healthcare formulated by the International Organization for Standardization (ISO) (2005) defines the phenomenon given as "the degree to which a set of inherent characteristics fulfills requirements" [41]. The Institute of Medicine (IOM) defines healthcare quality as the "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent", as cited in [42]. Mosadegrad (2013) defined high-quality healthcare as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patients' needs and satisfies providers" [16].…”