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Search results for "Incentives"
Journal Article > Study
Preventing hospital-acquired infections: a national survey of practices reported by U.S. hospitals in 2005 and 2009.
Krein SL, Kowalski CP, Hofer TP, Saint S. J Gen Intern Med. 2012;27:773-779.
The impact of the Centers for Medicare and Medicaid Services' (CMS) 2008 policy denying additional payment to hospitals for preventable complications, including certain health care–associated infections (HAIs), remains a subject of debate. This study assessed the effect of the CMS policy on use of infection control practices, using federal Veterans Affairs hospitals (which do not receive CMS payments) as a comparison group. Infection control practitioners at both federal and non-federal hospitals reported a greater organizational emphasis on HAI prevention and increased use of specific HAI preventive practices, over the time period before and after the CMS policy was implemented. This finding indicates that factors other than the CMS policy have driven efforts to reduce HAIs.
Cases & Commentaries
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Peter Lindenauer, MD, MSc; November 2006
A woman with end stage renal disease and heart disease on anticoagulation receives a pneumonia vaccination that causes a large hematoma.
The Commonwealth Fund Commission on a High Performance Health System. New York, NY: The Commonwealth Fund; August 2006.
This report calls for providing "safe, well-coordinated, accessible, and efficient" care through five key steps: expanding health insurance coverage, implementing evidence-based patient safety and quality interventions, increasing use of health information technology, public reporting of safety and quality measures, and rewarding achievement in quality through "pay-for-performance." The authors ascribe the current quality problems in the U.S. health care system to system failures, including misaligned payment incentives, inadequate motivation to challenge the status quo, inadequate information systems, duplicative regulatory systems, and an overemphasis on autonomy.
Journal Article > Study
McCarthy D, Blumenthal D. Milbank Q. 2006;84:165-200.
This study shares the efforts of six different health care organizations in implementing interventions to improve patient safety. All of the organizations identified culture change as the most important factor in promoting safety, though the mechanisms to achieve such change differed. The authors provide a contextual background of safety culture, including definitions, attributes, and strategies to approach the issue, and present a detailed account of each case study. They point out that creating a desired culture of safety may be both foundational to safety efforts and also very challenging to accomplish. The shared stories offer a practical perspective regarding the issues that face most organizations committed to improving patient safety.