Using Work Flow Analysis and Technology Assessment to Improve Performance on Quality Measures

摘要

FMQAI, a Medicare Quality Improvement Organization funded by the Centers for Medicare & Medicaid Services (CMS), works with Florida hospitals to improve their performance on measures that are used to determine the quality of health care given to Medicare patients. In 2006, FMQAI found a disconnect between Florida hospitals' health information technology (HIT) and their efforts to improve performance on quality measures. In short, hospitals were not optimizing the use of HIT to create or redesign processes to improve performance. To address this, FMQAI developed tools that hospitals can employ to link hospital quality measures to existing technology (Table 1, page 298). Automating the work flow for quality measures moves hospitals away from people-driven interventions-with all their inherent weaknesses, such as staff turnover, competing priorities, and variable work performance-and toward system-driven interventions, which have the potential to sustain improvement. This article describes two tools, with a focus on administration of pneumococcal vaccination as an example of their application-the Conceptual Diagram for automation and a Technology Assessment Tool. The Conceptual Diagram for automating pneumococcal vaccinations and the supporting Technology Assessment Tool help hospitals to map their work flow, identify human factors and cultural issues, obtain a coordinated view of current HIT, and develop recommendations for work flow changes and greater use of existing HIT capabilities to improve performance.