In the current atmosphere of closer scrutiny of healthcare practices and procedures, front-line managers and health care providers must investigate potential problems in their work environment, whether at the behest of upper management, in order to meet Joint Commission on Accreditation of Health Care Organizations (JCAHO) standards, or through their own sense that “weÆre doing something wrong.” For the investigator with limited previous experience in evaluation or research, the prospect of undertaking this kind of investigation can appear daunting, to say the least. Quality Improvement Projects in Health Care was written just for this individual. Author Eleanor Gilpatrick, a seasoned investigator and professor of health services administration, provides a review of the basic terminology and guidelines for carrying out “nuts-and-bolts” quality improvement research. She then demonstrates how such a research project can be implemented through 14 case studies involving actual health care situations. Altogether, the cases speak to a broad array of issues and potential pitfalls for the unwary investigatorŭand they show that progress can be made in even the most difficult circumstances. Quality Improvement Projects in Health Care will be of interest to students and professionals in health sciences administration, nursing, allied health, and public health.
Incomplete Laboratory Referrals in an HMO Center1
In this case, the problem was missing information in the orders for patients’ laboratory tests, but adherence to a current referral form proved to be an obstacle to improvement.
Proving the Problem
Edna was the supervisor of a laboratory center in a health maintenance organization (HMO). When a physician required laboratory tests, referral forms were filled out; the patient took them to the laboratory center, where staff drew blood or took other specimens and sent them to a clinical laboratory for testing. Edna was concerned that the referrals were sometimes too incomplete for staff to be able to proceed with specimen taking.
Edna initiated the quality improvement project on her own ...