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.
Chapter 4: Finding Solutions
In this instance, a municipal hospital was concerned about the length of stay of rehabilitation patients. While not subject to prospective payment restrictions, similar cost pressures nevertheless existed. The case was unusual because of the large number of possible causes that were examined.
Proving the Problem
A major municipal hospital's department of rehabilitation was concerned when its indicator data showed an unusually long length of stay for patients. This suggested the need for more intensive assessment, and patients recovering from amputations of the leg were selected for detailed study. Patients judged ready for rehabilitation were provided with assistive devices, including prostheses; they were ...