Biomaterial Database

Development of an outcomes management program at an academic medical center. 1996

M Morris, and S Jameson, and S Murdock, and D C Hohn

Medical Informatics, Houston, TX, USA. morris@ovp.mdacc.tmc.edu

BACKGROUND With the advent of managed care, academic medical centers have been challenged to lower costs and to document their claims of high quality outcomes. A successful method to achieve these objectives must not interfere with the academic missions of research and teaching. At M. D. Anderson Cancer Center, we initiated a program that would reduce practice variability and increase quality with a model that was familiar to the faculty. METHODS Professional staff members were divided into disease site groups that included physicians, nurses, and other allied health staff. Each group developed practice guidelines and Collaborative Care Paths, based on evidence in the publications and on expert opinion. Desired outcomes were prospectively defined during this process. Before implementation, paths and guidelines underwent peer review. RESULTS The faculty actively participated in the development and implementation of the program that was viewed as a means of empowerment to deal with managed care. Nearly 1000 patients have been entered on the B8 paths that have been implemented to date. CONCLUSIONS A physician-driven outcomes management program permits delivery of high quality care and supports outcomes research while decreasing cost in an academic setting.

UI	MeSH Term	Description	Entries
D010043	Outcome and Process Assessment, Health Care	Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.	Outcome and Process Assessment (Health Care),Donabedian Model,Donabedian Triad,Outcome and Process Assessment,Structure Process Outcome Triad,Model, Donabedian,Triad, Donabedian
D011367	Professional Staff Committees	Committees of professional personnel who have responsibility for determining policies, procedures, and controls related to professional matters in health facilities.	Committee, Professional Staff,Committees, Professional Staff,Professional Staff Committee,Staff Committee, Professional,Staff Committees, Professional
D002173	Cancer Care Facilities	Institutions specializing in the care of cancer patients.	Hospitals, Cancer,Cancer Care Facility,Cancer Hospital,Cancer Hospitals,Facilities, Cancer Care,Facility, Cancer Care,Hospital, Cancer
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000046	Academic Medical Centers	Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.	Medical Centers, Academic,Medical Centers, University,University Medical Centers,Academic Medical Center,Center, Academic Medical,Center, University Medical,Centers, Academic Medical,Centers, University Medical,Medical Center, Academic,Medical Center, University,University Medical Center
D013781	Texas	State bounded on the north by Oklahoma, on the east by Arkansas and Louisiana, on the south by Mexico, and on the west by New Mexico.
D016730	Program Development	The process of formulating, improving, and expanding educational, managerial, or service-oriented work plans (excluding computer program development).	Program Descriptions,Description, Program,Descriptions, Program,Development, Program,Program Description
D017146	Models, Organizational	Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.	Organizational Models,Model, Organizational,Organizational Model
D017410	Practice Guidelines as Topic	Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.	Clinical Guidelines as Topic,Best Practices,Best Practice
D019091	Critical Pathways	Schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment. (From Mosby's Medical, Nursing & Allied Health Dictionary, 4th ed)	Care Map,Care Pathways,Clinical Pathways,Clinical Paths,Critical Paths,Care Pathway,Clinical Path,Clinical Pathway,Critical Path,Critical Pathway,Map, Care,Maps, Care,Path, Clinical,Path, Critical,Pathway, Care,Pathway, Clinical,Pathway, Critical