Performance-Based Measures: The Early Results Are In

O'Kane, Margaret E

doi:10.18553/jmcp.2007.13.s2-b.3

Cited by 15 publications

(11 citation statements)

References 1 publication

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“…After a trial period with the PQRI, it is anticipated that pay for performance may be phased-in by the CMS for physicians, hospitals, other health plans, and possibly other providers. It remains to be proven if national pay for performance programs will actually promote higher quality of care and lower costs [18]. Without measuring performance and changing practices to improve efficiency and effectiveness, health care providers will be less likely to meet or exceed expectations.…”

Section: Paying For Performancementioning

confidence: 99%

Quality health care gaps in osteoporosis: How can patients, providers, and the health system do a better job?

Teng¹,

Curtis²

2009

Curr Osteoporos Rep

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A significant gap exists between evidence-based advances and real-world clinical practice in the diagnosis and prevention of osteoporosis. The goal of osteoporosis care is to prevent fractures and improve health-related quality of life, and ideally lower mortality. Despite recent advances in osteoporosis detection and treatment options, studies suggest underdiagnosis and undertreatment of osteoporosis, even among those who have already sustained fractures. The challenges in translating knowledge into practice are multifaceted, with efforts directed at the patient, provider, and health care system levels achieving variable success at the population level. Methods to improve quality of care in osteoporosis need to be multipronged, with emphasis on clinical process improvement and reliance on interdisciplinary teams. We review the growing literature on quality of care for osteoporosis.

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Section: Paying For Performancementioning

confidence: 99%

Quality health care gaps in osteoporosis: How can patients, providers, and the health system do a better job?

Teng¹,

Curtis²

2009

Curr Osteoporos Rep

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“…Fortunately, the recent health care reform has created a national impetus to promote safe, high quality care and eliminate costly, ineffective treatments. 20,21 Now is the opportune time to tackle the problems with DNR orders and push for quality DNR discussions that promote patient-centered care and prevent harmful interventions. In this article, we describe the persistent problems with hospital DNR orders in practice today.…”

Section: Introductionmentioning

confidence: 99%

Hospital Do-Not-Resuscitate Orders: Why They Have Failed and How to Fix Them

2011

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Do-not-resuscitate (DNR) orders have been in use in hospitals nationwide for over 20 years. Nonetheless, as currently implemented, they fail to adequately fulfill their two intended purposes-to support patient autonomy and to prevent non-beneficial interventions. These failures lead to serious consequences. Patients are deprived of the opportunity to make informed decisions regarding resuscitation, and CPR is performed on patients who would have wanted it withheld or are harmed by the procedure. This article highlights the persistent problems with today's use of inpatient DNR orders, i.e., DNR discussions do not occur frequently enough and occur too late in the course of patients' illnesses to allow their participation in resuscitation decisions. Furthermore, many physicians fail to provide adequate information to allow patients or surrogates to make informed decisions and inappropriately extrapolate DNR orders to limit other treatments. Because these failings are primarily due to systemic factors that result in deficient physician behaviors, we propose strategies to target these factors including changing the hospital culture, reforming hospital policies on DNR discussions, mandating provider communication skills training, and using financial incentives. These strategies could help overcome existing barriers to proper DNR discussions and align the use of DNR orders closer to their intended purposes of supporting patient selfdetermination and avoiding non-beneficial interventions at the end of life.KEY WORDS: do-not-resuscitate orders; informed consent; end-of-life care.

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“…based on those developed by the National Committee for Quality Assurance (NCQA) in partnership with the American Diabetes Association (ADA) and use evidence-based guidelines that describe ideal care for diabetic patients (O'Kane, 2007). The intermediate outcome measures included can be influenced by physician actions in the near term, such as intensification of therapy and are correlated with important longer term outcomes of microvascular and macrovascular complications of diabetes.…”

Section: Performance Measuresmentioning

confidence: 99%

Measuring Physicians’ Performance in Clinical Practice: Reliability, Classification Accuracy, and Validity

et al. 2010

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Much research has been devoted to addressing challenges in achieving reliable assessments of physicians' clinical performance but less work has focused on whether valid and accurate classification decisions are feasible. This study used 957 physicians certified in internal medicine (IM) or a subspecialty, who completed the American Board of Internal Medicine (ABIM) Diabetes Practice Improvement Module (PIM). Ten clinical and two patient-experience measures were aggregated into a composite measure. The composite measure score was highly reliable (r = .91) and classification accuracy was high across the entire score scale (>0.90), which indicated that it is possible to differentiate high-performing and low-performing physicians. Physicians certified in endocrinology and those who scored higher on their IM certification examination had higher composite scores, providing some validity evidence. In summary, it is feasible to create a psychometrically robust composite measure of physicians' clinical performance, specifically for the quality of care they provide to patients with diabetes.

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Performance-Based Measures: The Early Results Are In

Cited by 15 publications

References 1 publication

Quality health care gaps in osteoporosis: How can patients, providers, and the health system do a better job?

Quality health care gaps in osteoporosis: How can patients, providers, and the health system do a better job?

Hospital Do-Not-Resuscitate Orders: Why They Have Failed and How to Fix Them

Measuring Physicians’ Performance in Clinical Practice: Reliability, Classification Accuracy, and Validity

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