BACKGROUND To achieve improvement in healthcare quality and safety, all four domains (outcome, process, structure and culture) must be considered in conjunction with the best available clinical evidence to improve patient care and reduce harm. A range of improvement initiatives have targeted processes of care in recognition of: (1) complexities of patient care and (2) evidence that a large port...

BACKGROUND Pay for performance (P4P) initiatives are designed to foster and reward improvement in health care delivery. These programs promote "value-based health care" by rewarding quality care that is characterized by a reduced amount of disproportionate spending. OBJECTIVE To review the intent and design of P4P initiatives as well as the design and results of P4P programs in current practi...

The Health Administration field understands and deals with quality issues in a way that differs from what is seen in the industry. This article presents a survey done in a sample of 159 hospitals in São Paulo state during the second semester 1999 regarding the implementation of quality initiatives. The sample had public, philanthropic, non-philanthropic and university hospitals. Among 97 hospit...

LIBRARIES AND LIBRARIA~SMUST CHANGF significantly what they do in order to meet the challenges of the changing health care environment and the new technological era. Opportunities to strengthen partnerships, evolve new roles, and develop new high impact services in support of the clinical, research, and teaching are discussed. Quality initiatives in the management of health knowledge are descri...

T he Journal of Graduate Medical Education often receives submissions from trainees and educators highlighting work they do in quality improvement (QI). This is remarkably encouraging given the emphasis that the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System has placed on integrating QI into the clinical learning environment. A major challenge for editors...

Q uality rating and improvement systems (QRISs) have become an increasingly popular mechanism in states and localities seeking to raise the quality of their early care and education (ECE) programs. Typically, QRISs provide ratings of ECE programs based on multicomponent assessments designed to make quality transparent to parents and funders, as well as feedback, technical assistance, and financ...

Given the increased student interest in health research and the need to implement health research initiatives, the Multi-Organ Transplant Student Research Training Program provides student trainees with the opportunity to contribute to health research initiatives in transplant care. Program quality initiatives achieved include the development of a clinical research database, knowledge exchange,...