Continuity of care: Is it cost effective?

Raddish M, Horn SD, Sharkey PD. Continuity of care: Is it cost effective? American Journal of Managed Care. Jun 1999;5(6):727-734.

This article documents a study testing the correlation between continuity of care and cost-effectiveness in hospitals. The study, which is described in depth, concludes that continuity of care is in fact cost-effective and should still be promoted.

Patient decision aids for balancing the benefits and harms of health care options: A systematic review and meta-analysis

O'Connor AM, Stacey D, Llewellyn-Thomas H, et al. Patient decision aids for balancing the benefits and harms of health care options: A systematic review and meta-analysis. (Unpublished manuscript, May 2004.)

This unpublished manuscript documents the study done by Annette O'Connor, and her international team of colleagues, testing patient decision aids around the world. Decision aids help patients and members of their care team make "tough" decisions (i.e., those that have multiple options, or uncertain outcomes and harms). The decision aids help patients decide what path they should take with their care by making decisions based on their personal preferences and values.

 

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Learning to lead at Toyota

Spear SJ. Learning to lead at Toyota. Harvard Business Review. 2004 May;82(5):78-86, 151.

This article describes the experience of a new Toyota plant manager as he is fully immersed in the Toyota Production System (TPS).  The author contends that companies that try to take pieces from Toyota's model will never be able to duplicate the success because they often fail to recognize the underlying principles of TPS. 

Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States

Wennberg J, Fisher E, Stukel T, et al. Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States. British Medical Journal. March 2004;1-5.

This paper reports on a study conducted by Jack Wennberg, Elliott Fisher, and colleagues to evaluate the use of hospitals, physician visits, and hospice care by patients during the last six months of life.  The study, focusing on 77 hospitals with a reputation for high-quality care, found extensive variation in all measures.

 

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Quality improvement methods in clinical medicine

Plsek PE. Quality improvement methods in clinical medicine. Pediatrics. Jan 1999;103(1 Suppl E):203-214.

This article describes the methods and techniques used in quality improvement in health care.  The articles lists both simple solutions such as improvement teams within an organization to more recent solutions such as collaborative projects. 

Quality collaboratives: Lessons from research

Øvretveit J, Bate P, Cleary P, et al. Quality collaboratives: Lessons from research. Quality and Safety in Health Care. 2002;11:345-351.

This article describes a study of the effect and results of multi-organizational collaborative improvement projects in health care in North America, the UK, and Sweden. The article concludes that while some collaborative projects have led to improvement, there is still a marked difference between collaboratives and teams. 

 

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A framework for collaborative improvement: lessons from the Institute for Healthcare Improvement's Breakthrough Series

Kilo CM. A framework for collaborative improvement: Lessons from the institute for healthcare improvement's breakthrough series. Quality Management in Health Care. 1998;6(4):1-13.

Article explaining the Institute for Healthcare Improvement's Breakthrough Series.  Dr. Kilo describes the model in depth.

Obstacles to collaborative quality improvement: The case of ambulatory general medical care

Gandhi TK, Puopolo AL, Dasse P, et al. Obstacles to collaborative quality improvement: The case of ambulatory general medical care. International Journal for Quality in Health Care. 2000;12(2):115-123.

This article attempts to evaluate Collaborative improvement projects within ambulatory general medical care.  The article concludes that while improvement is possible, it is not easy to overcome obstacles within the hospital system. 

Breakthrough change for adult cardiac surgery in a community-based cardiovascular program

Doran KA, Henry SA, Anderson BJ. Breakthrough change for adult cardiac surgery in a community-based cardiovascular program. Quality Management in Health Care. Sep 1998;6(4):29-36.

This article describes the improvement achieved by a community hospital in the area of cardiac care through participation in an IHI Breakthrough Series Collaborative.

Continuous quality improvement for patients with back pain

Deyo RA, Schall M, Berwick DM, Nolan T, Carver P. Continuous quality improvement for patients with back pain. Journal of General Internal Medicine. 2000;15:647-655.

The article describes the discontinuity between evidence and practice when it comes to the care of back pain.  The article goes on to describe the improvements made by organizations who put this evidence into practice through an IHI Breakthrough Series Collaborative.