Does improving quality save money? : A review of evidence of which improvements to quality reduce costs to health service providers [printed text] / John Øvretveit, Author . - London [United Kingdom] : The Health Foundation, 2009 . - XIX, 95 p. : ill. ; A4. ISBN : 978-1-906461-17-1 : € 0,00 Languages : English ( eng)
| Descriptors: |
Indexation
Cost-effectiveness analysis ; England ; Health Care Costs ; Quality improvement ; Review Literature
Classification
W 84.4 Quality of health care (General)
|
| Abstract: |
This report reviews the evidence of whether improving quality can also save money for health service providers. It explores the cost saving potential of initiatives to improve quality and the barriers to success. |
| Contents note: |
Foreword vii -- Abstract ix -- Executive summary xi -- Outline of the review xi -- Poor quality and adverse events are common and costly xii -- Some interventions are effective, but carry costs which may exceed savings xii -- The cost and benefits of quality are spread over time and between stakeholders xiii -- Context factors influence whether a provider saves money from quality improvement xiv -- Providers would be helped by information relevant to their situation xiv -- Saving avoidable suffering may be speeded up by the business case xv -- Summary for health service providers xvii -- Does quality improvement save money for a service? xvii -- What is the actionable knowledge for service providers from the research? xviii -- How strong does the evidence need to be before we act? xviii -- How can providers ensure saving through quality improvement? xix -- PART 1: INTRODUCTION, OBJECTIVES AND METHODS 1 -- Chapter 1 Introduction 3 -- 1.1 A map of the literature 3 -- 1.1.1 Improving quality or quality improvement? 4 -- 1.1.2 The literature 5 -- Chapter 2 Concepts and terms 7 -- 2.1 Costs and savings 8 -- 2.1.1 A comment on the evidence 9 -- 2.2 Summary of conceptual distinctions made in this report 10 -- Chapter 3 Objectives, methods, and how the findings are presented 11 -- 3.1 How the research is presented to answer the questions 13 -- PART 2: EVIDENCE ABOUT COSTS AND SAVINGS 15 -- Chapter 4 Evidence of poor quality and costs 17 -- 4.1 General studies of poor quality 17 -- 4.1.1 Poor quality patient issues, dissatisfaction, complaints and negligence 17 -- Claims -- 4.1.2 Overuse, underuse, misuse and waste 18 -- 4.2 Adverse events and quality costs: general studies 18 -- 4.2.1 General adverse events studies 18 -- 4.3 Categories of adverse events: potential savings 20 -- 4.3.1 Hospital-acquired infections 20 -- 4.3.2 Adverse drug events 20 -- 4.3.3 Adverse events associated with surgery 21 -- 4.3.4 Pressure ulcers 22 -- 4.3.5 Patient falls 22 -- 4.3.6 Adverse events associated with ‘failure to rescue’ 22 -- 4.3.7 Communication and coordination failures 23 -- 4.3.8 Hospital discharge communications 23 -- 4.3.9 Other adverse events 24 -- 4.4 Conclusions: costs of poor quality and adverse events 24 -- Chapter 5 Solutions: evidence of effectiveness of interventions to reduce poor 27 -- quality, and their costs -- 5.1 Introduction 27 -- 5.1.1 ‘Reader alerts’ 27 -- 5.2 General improvement: evidence of effectiveness and intervention costs 28 -- 5.2.1 Nurse staffing 29 -- 5.2.2 Intensive care 30 -- 5.2.3 Interventions to reduce adverse drug events 30 -- 5.2.4 Computer solutions 30 -- 5.2.5 Improvements to communication and coordination: effectiveness 32 -- 5.2.6 Other interventions 33 -- 5.3 Quality improvement interventions: evidence of effectiveness and 35 -- intervention costs -- 5.3.1 Total quality management 36 -- 5.3.2 Continuous quality improvement projects 36 -- 5.3.3 Plan-Do-Study-Act cycle 37 -- 5.3.4 Statistical process control 37 -- 5.3.5 Process redesign, re-engineering, and Lean manufacturing 37 -- 5.3.6 Six Sigma 38 -- 5.3.7 Theory of constraints and mass customisation 39 -- 5.3.8 What is a ‘quality improvement intervention’ and what is an 39 -- ‘intervention to improve quality’? -- Chapter 6 Conclusions: savings to providers from improving quality 41 -- PART 3: CHALLENGES AND ENABLERS TO SAVING BY IMPROVING QUALITY 43 -- Chapter 7 The financial issues 45 -- 7.1 Features of finance systems 45 -- 7.1.1 Routine service payment schemes 45 -- 7.1.2 Penalties 45 -- 7.1.3 Incentives 46 -- 7.2 Costs and savings 46 -- 7.3 Conclusions 49 -- Chapter 8 The support issues 51 -- 8.1 Non-financial barriers to effective improvement 51 -- 8.1.1 Information 52 -- 8.1.2 Uncertainty and skill deficiencies 52 -- 8.1.3 Other urgent demands 52 -- 8.2 Enabling factors for improvement 53 -- 8.3 Financial and resource barriers to improvement 53 -- 8.3.1 Cost displacement (‘revenue displacement’) 53 -- 8.3.2 Investment resources and high initial intervention cost (‘capital costs’) 54 -- 8.3.3 Savings displacement 54 -- 8.4 Financial and resource enablers for improvement 54 -- 8.4.1 Provider bears the cost of poor quality 54 -- 8.4.2 Investment and capacity costs 55 -- 8.5 Conclusions 56 -- PART 4: FUTURE RESEARCH AND CONCLUSIONS 57 -- Chapter 9 Future research 59 -- 9.1 Future research 59 -- 9.1.1 Overall, how well does the research provide answers to the review 59 -- questions and where are the gaps? -- 9.1.2 Other observations about the research 61 -- 9.1.3 Future types of research needed 61 -- 9.1.4 Future research in the UK: proposed subjects 62 -- 9.2 Conclusions 63 -- APPENDICES AND BIBLIOGRAPHY 65 -- Appendix 1a Definition of terms used in the report 67 -- Appendix 1b Other common definitions and meanings 69 -- Appendix 2 Financial incentive schemes for improvement 71 -- 2.1 An overview of the relevant literature 71 -- 2.2 Financial incentives and penalties 72 -- 2.2.1 What are some of the schemes in operation? 72 -- 2.2.2 Pay for performance 74 -- 2.2.3 No pay for never events 75 -- 2.2.4 Discussion of schemes 76 -- 2.2.5 Do financial interventions, such as payments or other financial 76 -- rewards to providers or patients, improve safety? -- 2.2.6 Relevant literature on issues related to financial incentives for safety 76 -- 2.2.7 Information technology and financial incentives 78 -- Appendix 3 Context for quality improvement 79 -- 3.1 Contexts for successful implementation 79 -- 3.1.1 Safety culture 80 -- 3.1.2 Protection for and accountability of healthcare providers 80 -- 3.1.3 Context factors – general research 81 -- 3.1.4 Specific interventions – evidence of necessary conditions 80 -- Bibliography 83 |
| Link for e-copy: |
http://www.health.org.uk/public/cms/75/76/313/572/Does%20improving%20quality%20s [...] |
| Format of e-copy: |
PDF [Open Access] (769 Kb) |
| Record link: |
https://kce.docressources.info/index.php?lvl=notice_display&id=2513 |
|  |
Add the result to your basket Make a suggestion Refine your search Apply to external sourcesData.gouv.fr / Etalab (2011)
![Online [Open Access]](https://kce.docressources.info/styles/kce_cfess/images/globe.gif "Online [Open Access]")
Does improving quality save money? / London [United Kingdom] : The Health Foundation (2009)
Economic evaluation in cancer care in European journal of cancer, 36(2000)1 ([01/01/2000])
European Heart Journal / Oxford ; Melbourne ; New York : Oxford University Press - OUP (1980)
