Impact of Quality Assessment on Clinical Practice, Kaiser Permanente
Quality assessment is an important way to measure care and to effect change. The methods used vary from hospital to hospital and from small group practices to large healthcare practices like Kaiser Permanente (KP). Kaiser Permanente is an integrated healthcare delivery system that provides inpatient and outpatient care and is currently the largest managed care organization in the United States covering over 11.8 million members in eight states and the District of Columbia. With the introduction of the electronic health record (EHR) system in 2006, KP has been able to leverage the data collected to develop unique methods for assessing the quality of our clinical practices. For spinal care, KP has developed the KP spine registry which collects data on patient safety, spinal implant performance, and clinical outcomes. Added information on cost-effectiveness adds value to our quality measures. The most critical components after determining quality, however, is to implement a dynamic feedback mechanism in which changes in clinical practices can occur and can be shared throughout the entire organization. This chapter explores the different methods used by Kaiser Permanente to assess the quality of our spine care and implement changes in our clinical practices.
KeywordsRisk adjustment Quality reporting Kaiser Permanente Spine registry Electronic health record Dynamic feedback Risks calculators Quality control Chances in clinical practice Research Spinal implant surveillance
- 1.Debly T, Stewart J. The story of Dr. Sidney R. Garfield: the visionary who turned sick care into health care. Oakland: The Permanente Press; 2009.Google Scholar
- 3.Gliklich RE, Dreyer NA, editors. Registries for evaluating patient outcomes: a user’s guide [monograph on the Internet]. (Prepared by Outcome DEcIDE Center [Outcome Sciences, Inc dba Outcome] under Contract No. HHSA29020050035ITO1.) AHRQ Publication No. 07-EHC001-1. Rockville: Agency for Healthcare Research and Quality; 2007 Apr [cited 2012 May 8]. Available from: www.effectivehealthcare.ahrq.gov/repFiles/PatOutcomes.pdf
- 19.United States. U.S. Food and Drug Administration. Home Medical Device Safety Communications, Public Health Notifications (Medical Devices) – FDA public health notification: life-threatening complications associated with recombinant human bone morphogenetic protein in cervical spine fusion. Silver Spring: 2008. https://www.fda.gov/MedicalDevices/Safety/
- 20.Ohno T. Toyota production system: beyond large-scale production. New York: Productivity Press; 1988.Google Scholar