Composite model for profiling physicians across domains of care.

Physician profiling methods are envisioned as a means of promoting healthcare quality by recognizing the contributions of individual physicians. Developing methods that can reliably distinguish among physicians' performance is challenging because of small sample sizes, incomplete data, and physician panel differences. In this study, we developed a hierarchical, weighted composite model to reliably compare primary care physicians across domains of care, and we demonstrated its use within a clinical system.

The "physician-led chart audit: " engaging providers in fortifying a culture of safety.

Objectives: Engaging physicians in quality and patient safety initiatives is a well-described challenge. Barriers include time constraints, lack of defined common purpose and leadership support, poorly communicated goals, and scarcity of supporting data (references 1, 2, 3).With reference to strengthening a culture of safety while meeting regulatory and performance standards, health-care systems face a difficult twin objective: educate the medical staff and its trainees and maintain high levels of compliance across inpatient, ambulatory clinic, and procedural areas.

Impact of cardiac telemetry on patient safety and cost.

Background: With the impetus for healthcare reform and the imperative for healthcare organizations to improve efficiency and reduce waste, it is valuable to examine high-volume procedures and practices in order to identify potential overuse. At the same time, organizations must ensure that improved efficiency does not inadvertently reduce patient safety.

Methods: We undertook a multicenter analysis of the use of adult cardiac telemetry outside of the intensive care unit or step-down units at 4 teaching hospitals to determine the percentage of monitoring days that were not justified by an accepted indication and the monetary costs associated with these nonindicated days.

Physician quality officer: a new model for engaging physicians in quality improvement.

The slow progress in health care quality improvement and patient safety in America can be attributed, in part, to the challenge of physician engagement. As multidisciplinary patient-centered care becomes the standard, it is essential to integrate physicians into this process. To this end, the UMass Memorial Medical Center redesigned its Physician Quality Officer (PQO) program in 2007.