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The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [1] According to the model, information about quality of care can be drawn from three categories: "structure", "process", and "outcomes". [2]
The federal Health Care Quality Improvement Act ("HCQIA"), 42 U.S.C. § 11112, enacted in 1986, sets standards that professional review actions must meet in order to receive protection under the Act. It requires that the action be taken in the reasonable belief that it will advance healthcare quality based on facts obtained through reasonable ...
"a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change. Aspects of the structure, processes, and outcomes of care are selected and systematically evaluated against explicit criteria.
The Donabedian model is a common framework for assessing health care quality and identifies three domains in which health care quality can be assessed: structure, process, and outcomes. [14] All three domains are tightly linked and build on each other. Improvements in structure and process are often observed in outcomes.
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 ...
Traditional state-based legal protections for such health care quality improvement activities, collectively known as peer review protections, are limited in scope: They do not exist in all States; typically they only apply to peer review in hospitals and do not cover other health care settings, and seldom enable health care systems to pool data ...
In 2015 CMS identified 254 quality measures for which providers may choose to submit data. The measures map to U.S. National Quality Standard (NQS) health care quality domains: [4] Communication and Care Coordination; Community/Population Health; Effective Clinical Care; Efficiency and Cost Reduction; Patient Safety
High Performing Clinical Systems and Microsystems Approaches to Improvement – this category emphasizes structure and process in clinical care and healthcare as complex adaptive systems. Examples of Research Issues: Frontline provider engagement, factors related to uptake, adoption and implementation, sustaining improvements and improvement ...