Managing Quality

First published in 1999, this eclectic collection of papers examines quality management in health care from a variety of standpoints. Managers, health care professionals and patients all have valid - but often differing - perspectives on the nature of quality, its creation and maintenance. This book explores these perspectives, beginning by asking such fundamental questions as 'Is health care a business?', 'How should health services be designed?' and 'What is quality of care?'. Subsequent chapters then address the practicalities of measuring and improving health care quality. The chequered history of clinical audit is exposed in the UK (essentially the Plan-Do-Check-Act cycle familiar to quality improvement specialists), and lessons are drawn for managerial action needed to increase the impact of such activities. These lessons have wider relevance to all involved in promoting the principles of continuous quality improvement (CQI). In addition, exploration of the growing role of performance indicators raises important issues about their meaningfulness and instrumentality in effecting real change. Improving clinical quality is now at the top of the agenda for many health systems. This book reviews the challenges faced and the tools available to meet them. It should prove valuable to a wide range of health care stakeholders interested in broadening their understanding of this rapidly developing field.

H.T.O . Davies, M. Tavakoli, M. Malek, A. Neilson

Part 1. Scene Setting. 1. Is Health Care a Business? An Analysis of Health Care, and its Consideration as a Business. John L. Deffenbaugh. 2. Managing the Design of Health Care Services. Moira Fischbacher and Arthur Francis. Part 2. Quality in Health Care. 3. Towards Critical Quality. Mike Walsh. 4. Whose Quality? Different Interest Groups' Perspectives on Health Care Quality. Juan I. Baeza and Michael Calnan. 5. The Quantification of Patient Satisfaction. Mike Hart. 6. Managing Clinical Audit: Diagnosing the Problems and Designing Solutions. Gail Johnston, Huw T.O. Davies, Iain K. Crombie, Elizabeth M. Alder and Andrew R. Millard. 7. Improving Child Dental Health in Scotland: An Audit in Primary Care. Chris Southwick, Dafydd Evans and Huw T.O. Davies. 8. Human Resource Management Audits: Contributions to Quality. Sandra Nutley. Part 3. Using Performance Indicators. 9. What Are We Counting with Hospital Episode Statistics (HES)? Richard Wilson. 10. Clinical Outcomes Indicators in Scotland: Lessons and Prospects. Steve Kendrick, David Cline and Alan Finlayson. 11. What do Managers and Physicians Prefer as Indicators of Clinical Outcome? Régis Blais, Danielle Larouche, Pierre Boyle, Raynald Pineault and Serge Dubé. 12. Performance Indicators: A Patient-Centred Approach. Anne Ludbrook and Colin Gordon. 13. Is Indicator Use for Quality Improvement and Performance Measurement Compatible? Joanne Lally and Richard Thomson. 14. Published Health Outcomes: Guiding Lights or Wreckers' Lanterns? Huw T.O. Davies, Iain K. Crombie and Russell Mannion.