The official journal of the National Association for Healthcare Quality

Chaos and Complexity: Applications for Healthcare Quality and Patient Safety
Heidi Benson

Abstract: The new sciences of chaos and complexity are generating considerable interest within the social sciences, particularly with regard to organizational development, management, and leadership. This article explores potential applications of the concepts of chaos and complexity within the domains of healthcare quality and patient safety. 

Learning from Unexpected Events: A Root Cause Analysis Training Program
Stormy C. Sweitzer, Michael P. Silver

Abstract: Staff members need appropriate training before the investigation and causal analysis of accidents in any complex system. Otherwise results will be incomplete and will be focused on the least manageable contributors, such as the unsafe acts of frontline operators. This article outlines an incident investigation and root cause analysis workshop developed to address this training need in a spectrum of healthcare settings and reviews feedback from participants.

Challenges to Performance-Based Assessment for Community PhysiciansMelodie Blacklidge, Uma R. Kotagal, Lisbeth Lazaron, Pamela J. Schoettker, Melissa R. Kennedy, Michelle Stultz, Stephen Muething

Abstract: The Joint Commission on Accreditation of Healthcare Organizations requires accredited organizations to assess individual competency of physicians granted membership on the medical staff. At Cincinnati Children’s Hospital, a knowledge-based reappointment method was developed and implemented. Using a case-based self-test, the initial phase measured physicians’ knowledge of evidence-based guidelines for three common pediatric inpatient diagnoses. Future methods for tracking individual performance of community-based generalists at the time of reappointment were explored through a physician survey.

A Computerized Surveillance System for the Quality of Care in Childhood AsthmaRonit Peled, Asher Tal, Joseph S. Pliskin, Haim Reuveni

Abstract: A novel model for quality assurance of pediatric asthma was developed using administrative data and clinical guidelines. The model was validated by proving an association between inappropriate treatment (markers) and bad outcomes (emergency room visits, hospitalizations, and healthcare utilization).

Overcoming Challenges to Integrating Behavioral Health into Primary Care
Andrew Kolbasovsky, Leonard Reich

Abstract: This article identifies the challenges of integrating behavioral health specialists into primary care and describes strategies used to overcome these challenges.

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