Healthcare outcome boost needs better studies Research published in Medical Care Research and Review

Los Angeles, London, New Delhi, Singapore and Washington DC (June 25, 2009) – Evidence suggests that outcomes in many clinical settings leave a lot to be desired, which means that research into quality improvement (QI) in clinical care has the potential to greatly improve the lot of patients. Now a study in the journal Medical Care Research and Review published by SAGE suggests that both theoretical and practical improvements in QI effectiveness studies could make these into much more powerful tools for positive change.

Earlier research suggests that one in four hospital deaths may be preventable, a third of certain clinical procedures expose patients to risk without improving their health, a third of drugs are prescribed erroneously and one third of abnormal laboratory results are unresolved by clinicians in the US. QI focuses on understanding, controlling, and improving work processes, analyzing problems’ root causes, making work processes predictable, and then continuously improving process performance. Both patients and clinicians need QI.

In this new study published in Medical Care Research and Review, University of Michigan researchers Jeffrey Alexander and Larry Hearld reviewed 185 recent articles from clinical journals on QI’s effectiveness. Since that research is a developing area, they aimed to find out just how useful it is in providing managers and policy makers with evidence on the real impact of quality improvements.

Alexander and Hearld reviewed and compared QI research and interventions from hospitals (mostly university teaching hospitals), physician practices and other health care organizations, as well as nursing homes, looking at:

• research relevance in varied settings
• the relationship between organization and quality
• multiple interventions
• information technology
• consumer engagement in healthcare
• quality of care outcomes
• study designs
• assessment of intervention implementation

The authors recommend applying systems theory to QI research, and say that study designs would benefit from a multidisciplinary approach bringing onboard economists, organizational behaviorists, or other related disciplines. Today’s narrow focus on medical aspects of QI ignores the critical roles of organizational context, cost-effectiveness, and perhaps most important, the value added by the QI intervention to the patient or organization.

“What Can We Learn From Quality Improvement Research? A Critical Review of Research Methods” by Jeffrey A. Alexander and Larry R. Hearld is published by SAGE in Medical Care Research and Review and is free to access for a limited time at: http://mcr.sagepub.com/cgi/reprint/66/3/235.

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