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Pay for performance systems link compensation to measures of work quality or goals. Current methods of healthcare payment may actually reward less-safe care, since some insurance companies will not pay for new practices to reduce errors, while physicians and hospitals can bill for additional services that are needed when patients are injured by mistakes. [1]
In 2007, the US Institute for Healthcare Improvement proposed “whole system measures” that address structure, process, and outcomes of care. [10] These indicators supply health care leaders with data to evaluate the organization’s performance in order to design strategic QI planning.
Health care quality is the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes. [2] Quality of care plays an important role in describing the iron triangle of health care relationships between quality, cost, and accessibility of health care within a community. [3]
Performance is a measure of the results achieved. Performance efficiency is the ratio between effort expended and results achieved. The difference between current performance and the theoretical performance limit is the performance improvement zone. Another way to think of performance improvement is to see it as improvement in four potential areas:
The Malcolm Baldrige National Quality Award recognizes U.S. organizations in the business, health care, education, and nonprofit sectors for performance excellence. The Baldrige Award is the highest [2] formal recognition of the performance excellence of both public and private U.S. organizations given by the President of the United States.
The Healthcare Effectiveness Data and Information Set (HEDIS) is a widely used set of performance measures in the managed care industry, developed and maintained by the National Committee for Quality Assurance (NCQA). HEDIS was designed to allow consumers to compare health plan performance to other plans and to national or regional benchmarks.
The Healthcare Quality Improvement Act of 1986 (HCQIA) of the United States was introduced by Congressman Ron Wyden from Oregon. ( Title 42 of the United States Code , Sections 11101 - 11152) It followed a federal antitrust suit by a surgeon against an Astoria hospital and members of its clinic in which he claimed antitrust actions were ...
The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization helping to lead the improvement of health and health care throughout the world. [46] Founded in 1991 and based in Boston, Massachusetts , IHI works to accelerate improvement by building the will for change, cultivating promising concepts for improving ...