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An Approach to the Evaluation of Quality Indicators of the Outcome of Care in Hospitalized Patients, With a Focus on Nosocomial Infection Indicators

Published online by Cambridge University Press:  02 January 2015

The Quality Indicator Study Group
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Abstract

The Quality Indicator Study Group was created by the governing boards of three national professional organizations that have interest and experience in epidemiology, nosocomial infection control and prevention, and quality of care improvement. The Study Group has reviewed the existing literature concerning quality indicators (QIs), interviewed experts in the field, and focused on how best to evaluate such indicators, with an emphasis on nosocomial infection indicators as a paradigm for all QIs. In this report, we review pertinent issues and, where possible, provide specific advice on how to evaluate QIs and QI systems.

Type
SHEA Position Paper
Information
Infection Control & Hospital Epidemiology , Volume 16 , Issue 5 , May 1995 , pp. 308 - 316
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1995

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References

1. Public accountability of hospitals regarding quality: future directions; report of an invitational workshop sponsored by AHCPR December 3, 1993; Philadelphia, PA. The joint Commission 24mal on Quality Improvement 1994;20:7.Google Scholar
2. Braun, BI, Carr, MP, Cheng, AM. Hospital attributes associated with successful participation in a comparative performance measurement data base. Clinical Performance and Quality Healthcare 1994;2:242–250.Google Scholar
3. Berwick, D, Godfrey, A, Roessner, J. Curing Health Care. New Strategies for Quality Improvement. San Francisco, CA: Jossey-Bass; 1990.Google Scholar
4. Localio, AR, Hamory, BH, Sharp, TJ, et al. Comparing hospital mortality in adult patients with pneumonia: a case study of statistical methods in a managed care program. Ann Intern Med May 1995;122:125–132.Google Scholar
5. Health Care Reform-Report Cards’ Are Useful but Significant Issues Need To Be Addressed. Report to the Committee on Labor and Human Resources, US Senate, Washington, DC: US General Accounting Office; September 1994. GAO publication No. HEH-94-219.Google Scholar
6. Vibbert, S, Strickland, D, Migdail, K, et al. Major projects—Maryland quality indicator project. 1995 ed. In: Medical Outcomes and Guidelines Sourcebook. New York, NY:Faulkner and Gray; 1994:29–31.Google Scholar
7. Gaynes, R Nosocomial infection rates for inter-hospital comparison: limitations and possible solutions. Infect Control Hosp Epidemiol 1991;12:609–621.Google Scholar
8. Scheckler, WE. Interim report of the quality indicator study group. Infect Control Hosp Epidemiol 1994;15(4):265–268.Google Scholar
9. Chatfield, C. Problem Solving A Statisticians’s Guide. London, England: Chapman-Hall; 1988:8.Google Scholar
10. Gamer, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections. Am J Infect Control 1988;16:128–140.Google Scholar
11. New Classification of Physical Status. Anesthesiology 1963;24:111.Google Scholar
12. Owens, WD, Felts, JA, Spitznagel, EL Jr. ASA physical status classification: a study of consistency of ratings. Anesthesiology 1978;49:239–243.Google Scholar
13. Culver, DH, Horan, TC, Gaynes, Rp, et al. Surgical wound infection rates by wound class, operation, and risk index in U.S. hospitals, 19861990. Am J Med 1991; 91(suppl 3B):152S–157S.Google Scholar
14. Emori, TG, Culver, CH, Horan, TC, et al. National Nosocomial Infections Surveillance (NNIS) system: description of surveillance methodology. Am J Infect Control 1990;19:19–35.Google Scholar
15. Emori, TG, Gaynes, RF! An overview of nosocomial infections including the role of microbiology laboratory Clin Microbiol Rev 1993;6:428–442.Google Scholar
16. Larson, E, Horan, T, Cooper, B, Kotilainen, HR, Landry, S, Terry, B. Study of the definition of nosocomial infections (SDNI). Am J Infect Control 1991;19:259–267.Google Scholar
17. Lancaster, D, Willis, MA. Computer-assisted instruction (CAT): a time-saving, individualized teaching methodology. Am J Infect Control 1994;22:179–81.Google Scholar
18. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomiai infections in U.S. hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
19. Gross, PA Use of severity of illness indices. In: Mayhall, G, ed. Hospital Epidemiology and Infection Control. Baltimore, MD: Williams&Wilkins. In press.Google Scholar
20. Knaus, WA, Douglas, PW, Draper, EA, et al. Clinical investigations in critical care: The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest 1991:100:1619–1636.Google Scholar
21. Iezzoni, LI, Hotchkin, EK, Ash, AS, Schwartz, M, Mackieman, Y. MedisGroups databases: the impact of data collection guidelines on predicting in-hospital mortality. Med Care. 1993;31:277–283.Google Scholar
22. Ranson, JHC, Rifkind, KM, Roses, DE Fink, SD, Eng, K, Spencer, FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974;139:69–81.Google Scholar
23. Mayer, RJ, Rubenstein, E, Federman, DD, eds. Scientific American Medicine: Gastrointestinal Cancel: New York, NY: Scientific American Medicine Inc; 1986;VIII:1–18.Google Scholar
24. Horan, TC, Gaynes, RP, Mortone, WR, Jarvis, WG, Emori, TG. CDC definition of nosocomiai surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.Google Scholar
25. The Guide to Hospital Performance. Baltimore, MD: HCIA Inc.; 1993.Google Scholar
26. Fine, MJ, Singer, DE, Hanusa, BH, Lave, JR, Kapoor, WN. Validation of a pneumonia prognostic index using the MedisGroups Comparative Hospital Database. Am J Med 1993;94:153–159.Google Scholar
27. Acuity Index Method database. Iameter, San Mateo, CA.Google Scholar
28. Berwick, DM. The clinical process and the quality process. Qual Manage Health Care 1992;1:1–8.Google Scholar
29. O’Leary, DS. The measurement mandate: report card day is coming. J Qual Improvement 1993;19:487–491.Google Scholar
30. Kritchevsky, SB, Simmons, BP Continuous quality improvement. Concepts and applications for physician care. JAMA 1991;266:1817–1823.Google Scholar
31. Kritchevsky, SB, Simmons, BP Variation in medical practice: implications for the hospital epidemiologist. Infect Control Hosp Epidemiol 1994;15:116–119.Google Scholar
32. Laffel, G, Blumenthal, D. The case for using industrial quality management science in health care organizations. JAMA 1989;262:2869–2873.Google Scholar
33. Merry, MD. Total quality management for physicians: translating the new paradigm. QRB Qual Rev Bull 1990;16:101–105.Google Scholar
34. Scheckler, WE. Continuous quality improvement in a hospital system: implications for hospital epidemiology. Infect Control Hosp Epidemiol 1992;13:288–292.Google Scholar
35. Sellick, JA Jr. The use of statistical process control charts in hospital epidemiology. Infect Control Hosp Epidemiol 1993; 14:649–656.Google Scholar
36. Institute of Medicine. Clinical Practice Guidelines: Directions for a New Program. Committee to Advise the Public Health Service on Clinical Practice Guidelines. Field, MJ, Lohr, KN, eds. Washington, DC: National Academy Press; September 1990.Google Scholar
37. Kenkel, PJ. Health plans face pressure to find ‘report card criteria that will make the grade. Modern Healthcare January 10, 1994;24:(2):41–42.Google Scholar