Beyond generic occurrence screening

Article Abstract:

Performance data are now being used as one measure for selecting good hospitals and physicians. Such data are reviewed by Sanazaro and Mills in the April 17, 1991 issue of The Journal of the American Medical Association. However, there are severe limitations to these techniques. Sensitive and specific performance measures must be developed. Sensitive measures identify most or all of the cases (such as cases of adverse patient outcomes) being measured. Specificity means that only the cases that are relevant are included, that is, no cases of an event are identified falsely (known as false-positive). Risk management is an important part of quality control, but there are issues that go beyond it to include the quality of care. Quality is made up of appropriateness, effectiveness, and continuity of care, as well as patient satisfaction and other elements. Performance measures are divided into two types: sentinel events, which always require review; and rate-based measures, such as mortality following specific types of surgery. These measures can be used to evaluate individual or organizational performance, but it must be remembered that the two are connected. Peer review committees remain important, and new methods of handling and analyzing data will broaden their role. But it must be remembered that no statistical analysis is meaningful unless the data are properly collected. The data that are included in the medical record must be informative, and there must be monitoring. Whether these efforts will contain health care costs, improve patient care, and produce medical value for the money remains to be seen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Hospitals, Medical care, Quality management, Medical care quality, Joint Commission on Accreditation of Healthcare Organizations, editorial, Peer review committees

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Physician clinical performance assessment: prospects and barriers

Article Abstract:

Many problems need to be overcome to create a system that can evaluate a doctor's performance. Most doctors are evaluated based on patient outcomes or the doctor's adherence to clinical practice guidelines. These are called outcome and process assessments. Unfortunately, there is no broad infrastructure in place to collect this data.

Offices & clinics of medical doctors, Physicians & Surgeons, Offices of Physicians (except Mental Health Specialists), Clinical competence

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