COLLEGE OF HEALTH AND HUMAN SERVICESCalifornia State University, Long BeachHealth Care Administration Department

HCA 450-01: Quality Improvement/Management in Health Care DeliverySUMMER 2017

Instructor: Rus Billimoria, MD, MPH, CPHQE-mail: rus.billimoria@csulb.edu

Office Hours: By appointment only on day of the class. Available for telephonic consultations as requested on any day. Please call for appointments.

Phone: (626) 943 6280Cell: (310) 508 1472

Class Number: 10388 , Section-01Class Location: HHS Bldg 1, Room # 101

Class Meets: May 31 – July 5, 2017Mondays & Wednesdays from 6:00 PM to 10:00 PM

Additional Contact Information:HCA Program Administrative Coordinator: Deby McGill, dmcgill@csulb.eduTel. 562/985-5694; fax 562/985-5886

Catalog Description

Prerequisites: HCA 300. (Please refer to details below) and HCA 465 (Preferred)

Basic elements of quality improvement and organizational responsibilities related to quality improvement in health care delivery. Data analysis for quality improvement, clinical practice guidelines, and future of healthcare quality improvement strategies.

Letter grade only (A-F). (Lecture)

Instruction Mode: In Person

Course Objectives

Quality health care has become a worldwide goal. Communities around the world are now increasingly involved with effectuating the value proposition in healthcare, and the science of health care quality is advancing rapidly. The current economic challenges caused by a worldwide recession have created ideal conditions for change”1. The purpose of this course is to familiarize the student with the concept of Quality and the process of Quality Improvement across the Health Care continuum. This course focuses on the history and evolution of quality, its terms, principles, theories, and practices. The student is introduced to a diverse collection of methods of improving quality, including but not limited to continuous Quality Improvement and Total Quality Management, and to the guidelines for implementing quality management and the continuous quality improvement processes. Students will be familiarized with Six Sigma and other tools that are an integral component of Process Improvement and Customer Satisfaction. The value proposition is now an integral part of Quality Improvement and is discussed in detail.

1 Advanced Performance Improvement in Health Care, Principles and Methods, Donald Lighter, 2011, Jones and Bartlett, Boston

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Additionally , the students will be asked to review the changes that a selected number of health care systems from across America have implemented in order to achieve the Institute of Medicine’s goals to make quality health care more safe, timely, effective, equitable, efficient, and patient-centered.

Learning Objectives, Domain and Competency Table

Learning Objective Domain Competency Activity (A1), Assignment (A2) or Assessment (A3)

Understand and evaluate the implications and effects of regulation, legislation and accreditation to Health Care Quality Improvement

Knowledge of the Healthcare Environment(4)

Healthcare Systems and Organizations (A)

Lecture, Short EssayAnd Class Discussion

Understand and discuss Quality, Efficiency, Return on Investment, Access to health care and Quality implications

Business Skills and Knowledge (5)

Quality Improvement (H)

Lecture, Discussions, Project & Paper

Discuss, and Understand Customer Satisfaction via Application of Quality Improvement Strategies, Philosophies, and Techniques

Business Skills and Knowledge (5)

Quality Improvement (H)

Lecture, Discussions, Project and Case studies

Understand, discuss Incentive Payments for Quality Health Care

Knowledge of the Healthcare Environment(4)

Healthcare Systems and Organizations (A)

Lecture, Discussions, Paper or classroom projects

Understand and Discuss Quality Improvement in Various Delivery Settings

Knowledge of the Healthcare Environment(4)

Healthcare Systems and Organizations (A)

Lecture, Discussion, Project and Case studies

Expected Student Learning Outcomes

On completion of this course, the student will be able to:

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1. Describe the evolution of the health care systems and Quality Management/Improvement Programs up to the present and reflect on its future.

2. Understand the reasoning and the importance behind the requirements for Quality Management/Improvement Programs in the health care environment.

3. Describe the current state-of-the-art Quality Management/Improvement Program principles and techniques for health care in general. This includes the principles of Continuous Quality Improvement, Total Quality Management, and proactive versus reactive Quality Management programs.

4. Understand the impact of federal and state legislation on Quality Management/Improvement Programs in Health care.

5. Understand the need for and development of standards for accreditation of health care entities.

6. Describe the recent impact of consumers on health care Quality Management/Improvement Programs and the development of Report Cards for provider and managed care organizations (HEDIS etc.).

7. Relative Resource Use- Analysis and Quality Improvement implications

8. Understand the use of data and statistics for effective Quality Management/Improvement Programs. This includes the development and use of various Quality Improvement tools for process improvement and improving customer satisfaction.

9. Understand Six Sigma and Lean Strategies.

10. Understand basic elements of provider credentialing, risk management and liability issues as they relate to the Quality Management/Improvement Programs.

11. Understand the effect of Patient Safety issues on Quality Management/Improvement systems.

12. Understand the recent trends in Quality Management/Improvement and Continuous Quality and Continuity of Care issues in Assisted Living, Skilled Nursing, and Long Term Care.

13. Demonstrate understanding of the principles behind development of Quality Management/Improvement Programs and processes for a health care entity via successful completion of class project.

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Text(s) and other course materials

This course does not prescribe a specific text, since no single text would cover the broad scope of this course. However, the following books and materials are strongly recommended for review:

1. Spath, Patrice, 2013, Introduction to Healthcare Quality Management, 2nd Edition, Copyright 2013, Health Administration Press, Chicago, IL; ISBN 978-1-56793-593-6

2. Moin, Tannaz; Scales, Charles; Sinay, Tony; 2014, Principles of Healthcare Quality Management: : Tools and Applications (EBook), Copyright 2014, Kendall Hunt Publishing Company; ISBN 978-1-46528-584-3 . However, the e-book version is available online at a lower price through the VitalSource website (see the following link): https://www.vitalsource.com/products/principles-of-healthcare-quality-management-tools-tannaz-moin-charles-scales-v9781621784159

3. Lecture notes and handout materials 4. A list of References is presented at the end of the syllabus. Students are encouraged

to use this reference material for enhancing the information discussed in class. In addition, generous use of the information may be made for class papers and project assignments

Types of Assignments, Basis for Assigning the Course Grade and Sequence of Assignments

1) Short Essay Papers

To understand the latest trends in Quality Management/Improvement Program it is necessary to review articles related to health care quality from professional medical or health care journals. All class sessions incorporate discussions on the latest trends presented in these journal articles. Students will be expected to read and summarize assigned articles or readings in the form of short papers (a maximum of two, doubled spaced and typed pages).

Examples of Journal materials that may be the subject of your reviews are as follows:

a) Journal of the American Medical Association (JAMA) - http://jama.ama-assn.org/

b) New England Journal of Medicine - http://content.nejm.org/ c) Annals of Internal Medicine - http://www.annals.org/ d) Journal of Health Politics, Policy and Law - http://www.jhppl.org/ e) Journal of HealthCare Quality - http://www.allenpress.com/jhq/ f) Med Bio World - Hospital & Healthcare Management Journals -

http://www.medbioworld.com/

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The summaries should be well thought out. The following is a suggested format for your papers.

1) Introduction – Reason for selecting the article.2) Ideas or thoughts presented by the article.3) Your analysis of the article and a critique.4) Conclusions that may be derived from the article.

The short essay papers will be graded on a scale of zero – 20 points. Grading will be based on the following criteria:

1) Selection and current relevance of the topic for review.2) Clear presentation of the ideas and thoughts from the article.3) Your analysis of how the article corresponds to current issues and trends

in Health Care Quality.4) Writing style.5) Clarity of presentation, grammar and spelling.

Short essay paper will be due on the week assigned. Please see agenda on the following pages. The papers must be well presented. Submit one hard copy to the instructor. The copy will be returned.

2) Class Participation

Active classroom participation is encouraged. Participation will include in classroom projects. Each student will have adequate opportunities to participate in classroom discussions and projects assigned. Level of participation will contribute towards the overall course grade.

3) PROJECT: Quality Management/Improvement Program/Project Development

A major classroom project will be the development of a Quality Improvement project for a health care entity, to be assigned the second week and presented in the final week of the course. Students will form teams and develop a Quality Management/Improvement project of their selection for an entity or scenario selected by students. The program development or project will make use of principles and standards presented during the course. Each student within a team will make specific contributions to the program development. The programs or projects developed will be presented to the class by all student representatives from each team. Please see course agenda below for timelines. Guest speakers may be present during presentations and will contribute to the discussions.

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Grading For “The Quality Management/Improvement Program Development Project":

I Each student’s contribution towards the team project will be presented in form of a paper not less than two double-spaced type written pages. The paper shall comprise of the following elements:

a) Introduction to the portion being contributed by the student. (20% of the total Project Grade)

b) Presentation of the ideas and components the student is responsible for(40% of the Project Grade)

c) Discussion on the importance of the student’s contribution towards the team project using the principles and theories discussed in class as well as pertinent literature reviewed by the student. (40% of the Project Grade)

d) Include any literature support used.

II Class Presentation by Team (100% of the Project Grade)

Presentation Scoring Rubric will consider the following:

All 7 Elements listed below must be covered in your Presentation

1. Outline the research documenting need for healthcare improvement2. Define the system in which you are making improvements3. Identify key themes for improvement efforts4. Use the improvement processes best suited for your project5. Develop and Describe the team meeting management skills used to

accomplish your project6. Describe basic steps used in managing change as you implemented your

improvement plan7. Describe the value and context for the tools your team used and

implemented in settings you used:

Fishbones Process mapping Flow charting Run/control charts

4) Final Exam for HCA 450 (Constitutes approx. 30% of the Overall Class Grade)

HCA 450 students will be administered a final exam worth approximately 30% of the overall class grade. The exam will comprise of multiple questions. Questions will be a mix of essay type discussions and short problems based on case studies using the knowledge from topics discussed in class and the prescribed text book during the semester and a series of short case studies or notes on specific issues or topics.

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For each essay question, the student will be required to use the following format:

a) An Introduction to address the case or problem presented b) Presentation of the ideas in addressing the issue or case using information from

the course.c) Brief Discussion of the interventions or direction suggested by the student for

addressing the case or issue d) Conclusion- Summary of thoughts

Length of the written answer is left to the discretion of the student. It is important to ensure that the above four points be taken into consideration for a complete answer. In general two type written pages with a reasonable font size (11 or 12) would be adequate.

5) Comprehensive QUIZ (Approx. 10 % of overall grade) : One Comprehensive Quiz will be offered during the semester. This will be announced a week prior to the quiz giving adequate preparation time to the students.

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AGENDA

Week Objective Week 1 – May 31 a) Introduction to the course.

b) Literature Review Guidelines.c) Introduction to Terminologies.d) Introduction to Health Care Systemse) Selection of Teams (8) & Team Leaders for projects.

Week 2 – June 5 a) Evolution of Health Care Quality Management. b) Introduction to Quality Improvement (Lecture Notes)

c) Discuss Quality Improvement ProjectReadings: Review Chapters 1 (Prescribed Text Book)-

Defining Quality, What is Quality? Business Case for Quality – Reading for class project

Week 2 – June 7 a) Basic Elements of Quality Improvement (Lecture Notes)b) The Deming approach to Quality Improvement.c) Continuous Quality Improvement (CQI) and

Total Quality Management (TQM) d) Classroom Project-Business case for Quality Readings: Chapter 2 (Prescribed), Quality Building Blocks

Week 3 – June 12 Topic for Essay # 1 to be announced in class

a) Continuous Quality Improvement –Thoughts b) Process Flow Diagrams Review: Chapter 3 (Measuring Performance)

Essay # 1 to be submitted in classWeek 3 – June 14 a) Beyond Ishikawa

b) Performance Improvement Tools for Quality- Introduction with Fishbone Diagram & Root Cause Analysis (Lecture Notes) c) Discuss FOCUS and Pareto Charts (Lecture notes) d) Draw Fishbone- in class exercise

Review: Chapter 6 (Performance Improvement Tools) and Chapter 7 (Improvement Project Teams)

Week 4 – June 19 a) Leadership and Quality Improvement Teams (Lecture notes)b) Progress Report and Updates on the Quality Improvement

project by each team.Review: Chapters 4 (Page 100) and Chapter 5

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:

Week 4 –June 21 a) Variations (Lecture Notes)b) Plan Do Study Act (Using more Tools)c) Principles and Tools for Quality Part I (Lecture Notes)d) Using Quality Improvement Tools- Small Classroom Project

Review: Chapter 6 (Performance improvement Tools)

Week 5 – June 26 a) Principles and Tools for Quality Part II (Lecture Notes)b) Using Quality Improvement Tools- Small Classroom

Project

Review: Chapter 6 (Performance improvement Tools)

Week 5 – June 28 a) Control Chartsb) Six Sigma and Lean (Lecture Notes)c) Small Classroom Project Presentations by Teams

Review: Chapter 6 (Six Sigma)

Week 6 – July 3a) Understanding Regulatory Requirements b) Accreditationsc) Safety and Qualityd) Pay for Performance

Week 6 – July 5 Finals Class PresentationsSubmission of Project Summary Contribution papers

Withdrawal policy

Withdrawal after 2nd week and before final 3 weeks “permissible for serious and compelling reasons;” include statement of how you will interpret university policy.

BASIS FOR ASSIGNING THE COURSE GRADE

This being a double numbered course, university policy requires greater expectations, additional work and different grading scales for graduate students. Due importance will be given to student participation in projects, papers, class work and exams. Letter Grades are assigned from A-F for level of achievement in the course. For final computation of the letter grades, following weights for each course component will be used:

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Component HCA 450 Percent of Grade

Short Essays: #1 10%

Comprehensive QUIZ 10%

Finals Exam Paper 30%

Final Exam

Development of a Quality Management Program Project

30%

Class Participation (Including Attendance and at least two in class projects)

20%

TOTAL 100%

STUDENT RESPONSIBILITIES AND EVALUATION

AttendanceStudents are required to attend and to be prepared for each session by reading any assigned or referenced materials. Attendance is expected at each class session. However, if there are compelling circumstances, an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to date with the class material.

Drops

It is the responsibility of the student to file for a drop status if he or she desires. No drops will be signed by the instructor after the second week for the accelerated program.

Attendance policy

Students are required to attend and to be prepared for each session by reading any assigned or referenced materials. Attendance is expected at each class session. However, if there are compelling circumstances, an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to date with the class material.

Disabled students

ADA Accommodation will be provided to any student who requests such, as defined by the ADA act and CSULB. Please contact Dr. Billimoria or refer to your student handbook for further information. It is the student’s responsibility to notify the lecturer in advance of the need for accommodation of a disability that has been verified by the university.

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Cheating and plagiarism

The following is excerpted from the California State University, Long Beach Policy Statement 85-19, dated December 13, 1985.

It is the policy of the faculty and administration to deal effectively with the student who practices cheating or plagiarism. These acts are fundamentally destructive of the process of education and the confident evaluation of a student's mastery over a subject. A University maintains respect and functions successfully within the larger community when its reputation is built on honesty. By the same token, each student benefits in helping to maintain the integrity of the University. This policy, therefore, provides for a variety of faculty actions including those which may lead to the assignment of a failing grade for a course and for administrative actions which may lead to dismissal from the University. It is the intent to support the traditional values that students are on their honor to perform their academic duties in an ethical manner. GENERAL:

The following definitions of cheating and plagiarism shall apply to all work submitted by a student.

DEFINITION OF PLAGIARISM:

Plagiarism is defined as the act of using the ideas or work of another person or persons as if they were ones own, without giving credit to the source. Such an act is not plagiarism if it is ascertained that the ideas were arrived at through independent reasoning or logic or where the thought or idea is common knowledge.

Acknowledge of an original author or source must be made through appropriate references, i.e., quotation marks, footnotes, or commentary. Examples of plagiarism include, but are not limited to, the following: the submission of a work, either in part or in whole, completed by another; failure to give credit for ideas, statements, facts or conclusions with rightfully belong to another; in written work, failure to use quotation marks when quoting directly from another, whether it be a paragraph, a sentence, or even a part thereof; close and lengthy paraphrasing of another writing or paraphrasing should consult the instructor.

Students are cautioned that, in conducting their research, they should prepare their notes by (a) either quoting material exactly (using quotation marks) at the time they take notes from a source; or (b) departing completely from the language used in the source, putting the material into their own words. In this way, when the material is used in the paper or project, the student can avoid plagiarism resulting from verbatim use of notes. Both quoted and paraphrased materials must be given proper citations.

DEFINITION OF CHEATING:

Cheating is defined as the act of obtaining or attempting to obtain or aiding another to obtain academic credit for work by the use of any dishonest, deceptive or fraudulent means.

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Examples of cheating during an examination would include, but not be limited to the following: copying, either in part or in wholes, from another test or examination; discussion of answers or ideas relating to the answers on an examination or test unless such discussion is specifically authorized by the instructor; giving or receiving copies of an exam without the permission of the instructor; using or displaying notes; "cheat sheets," or other information or devices inappropriate to the prescribed test conditions, as when the test of competence includes a test of unassisted recall of information, skill, or procedure; allowing someone other than the officially enrolled student to represent the same. Also included is plagiarism, which is defined as altering or interfering with the grading procedures.

It is often appropriate for students to study together or to work in teams on projects. However, such students should be careful to avoid use of unauthorized assistance, and to avoid any implication of cheating, by such means as sitting apart from one another in examinations, presenting the work in a manner which clearly indicates the effort of each individual, or such other method as is appropriate to the particular course.

ACADEMIC ACTION:

One or more of the following academic actions are available and may be invoked by the faculty member who finds a student has been cheating or plagiarizing.

a) Review -- no action. b) An oral reprimand with emphasis on counseling toward prevention of further occurrences; c) A requirement that the work be repeated; d) Assignment of a score of zero (0) for the specific demonstration of competence, resulting in the

proportional reduction of final course grade; e) Assignment of a failing final grade; f) Referral to the Office of Judicial Affairs for possible probation, suspension, or expulsion

In addition students may refer to the following website for information. http://www.csulb.edu/divisions/aa/grad_undergrad/senate/documents/policy/2008/02.

Additional information resources

Students interested in acquiring more information on the university syllabus policy please go to the Faculty Center for Professional Development website at: http://www.csulb.edu/divisions/aa/personnel/fcpd/.

The faculty handbook can also be found online at the following link: http://www.csulb.edu/divisions/aa/personnel/documents/2006FacultyHandbook_REV-2-08-07_000.pdf

ADDITIONAL INTERNET RESOURCES FOR HCA 450:

America’s Health Insurance Plans www.ahip.orgAmerican College of Medical Quality www.acmq.orgAmerican Health Information Management Association www.ahima.org

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American Health Information Management Association http://www.ahima.org/American Healthcare Association www.aha.orgAmerican Society for Healthcare Risk Management www.ashrm.orgAmerican Society For Healthcare Risk Management http://www.ashrm.org/ashrm/index.jspAssociation for Quality www.asq.orgassociation for quality http://www.asq.org/California Association for Healthcare Quality www.cahq.orgCalifornia Code of Regulations http://ccr.oal.ca.gov/California Department of Corporations www.corp.ca.govCalifornia Medical Association www.cmanet.orgJoint Commission on Accreditation of Healthcare Organizations

www.jcaho.org

Medicare www.cms.hhs.govNational Guideline Clearinghouse www.guideline.govNational Library of Medicine www.nlm.nih.govNational Network of Libraries of Medicine www.nnlm.govQuality Indicator Project www.qiproject.org

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COURSE BIBLIOGRAPHY

For convenience, Course Bibliography is presented in two sections. Section 1 includes published articles over the past 5 years (2012-2017) that are most relevant to this course. Lectures include information from these readings. Section 2 includes older published literature that is currently relevant and includes many a classic writing that continues to be included in current teachings. For both sections, the references are organized alphabetically by last name of primary author.

Section 1: 2012-2017

1. Davies, S. et al, Impact of including Readmissions for qualifying events in the patient safety indicators; American Journal of Medical Quality 2015, Vol. 30(2) 114–118.

2. Feldman, Joshua, et al; Measuring and Improving Cervical, Breast and Colorectal Cancer Screening rates in a multisite Urban Practice in Toronto Canada; BMJ Quality Improvement Reports 2017;6:u213991.w5531. doi:10.1136/bmjquality.u213991.w5531

3. Frist, William H., Connected Health and rise Of the Patient-Consumer, Health Affairs, 33, no.2 (2014):191-193.

4. Gallagher, Thomas H and Mazor Kathleen, M; Taking Complaints Seriously: using the patient safety lens, BMJ Qual Saf 2015; 24:352–355.

5. Graber, Mark I, et al, JAMA, September 26, 2012—Vol 308, No. 12, 1211-1212.

6. Harder, B., Comarow, A., Hospital Quality Reporting by US News and World report: Why, How and What’s Ahead, JAMA May 19, 2015 Volume 313, Number 19; 1903-1904

7. Hebert, Philip C, Disclosure after large scale events: Price of honesty? BMJ Qual Saf 2015;24:293–294.

8. Hero, J., Blendon, R., Zaslavsky, A., and Cambell, A.,Understanding What MakesAmericans Dissatisfied With Their Health Care System: An International Comparison, Health Affairs, March 2016 vol. 35 no. 3 502-509

9. Himmelstein ,David U., MD, Steffie Woolhandler, MD, MPH,Letter- Physician Payment Incentives to Improve Care Quality, JAMA January 15, 2014 Volume 311, Number 3, 304.

10. Iglehart , John K., Mission Versus Reality In Emergency Care, Health Affairs, 32, no.12 (2013):2066.

11. James III, A. Everette,J D, Gellad Walid F., MD and Primack Brian A., MD, Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement JAMA January 15, 2014 Volume 311, Number 3.

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12. Liberatore Matthew J., (2013) "Six Sigma in healthcare delivery", International Journal of Health Care Quality Assurance, Vol. 26 Issue: 7, pp.601 – 626.

13. Meltze ,David O. and Chung,Jeanette W., The Population Value Of Quality Indicator Reporting: A Framework For Prioritizing Health Care Performance Measures, HEALTH AFFAIRS 33, NO. 1 (2014): 132–139.

14. Oostrom Tamar et al; Outpatient Office Wait Times and Quality Of Care For Medicaid Patients; HEALTH AFFAIRS 36, NO. 5 (2017): 826–832

15. Ouyang, Helen; The art of Discharge; JAMA May 26, 2015 Volume 313, Number 20, 2027-2028.

16. Papanicolas ,Irene, Cylus ,Jonathan and Smith Peter C., An Analysis Of Survey Data From Eleven Countries Finds That 'Satisfaction' With Health System Performance Means Many Things, Health Affairs, 32, no.4 (2013):734-742.

17. Perlin, Jonathan B., Rapid Core Measure Improvement Through a “Business Case for Quality” Journal for Healthcare Quality, Mar/April 2012, Vol. 36, No. 2, pp. 50–61.

18. Pincus Harold, Scholle, Sarah H., Spaeth-Rublee, Bridgitta., Hepner, Kimberly and Brown Jonathan. Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges, Health Affairs, June 2016 vol. 35 no. 6 1000-1008.

19. Platonova, E and Shewchuk, R.; Patient Assessment of Primary Care physician Communication: Segmentation approach; International Journal of Health Care Quality Assurance, Vol 28, No. 4, 2015, 332-334.

20. Portela, M.C., et al, How to study improvement interventions: A brief overview of study types; BMJ Qual Saf 2015;24:325–336.

21. Presec Madeline, et al, Primary Health Care That Works: The Costa Rican Experience; HEALTH AFFAIRS, 36, NO. 3 (2017) 531-538.

22. Roberts, Eric T., et al; High Price and Low Price Physician Practices Do Not Differ Significantly On Care Quality or Efficiency; HEALTH AFFAIRS 36, NO 5. (2017), 855-864

23. Robert Shauna R. et al, Addressing Social Determinants to Improve HealthCare Quality and Reduce Cost, Journal for Healthcare Quality, Vol. 34, No. 2, 2012 pp. 12–20.

24. Roland Martin, D.M., and Campbell Stephen, Ph.D. Successes and Failures of Pay for Performance in the United Kingdom, N Engl J Med (NEJM)370;20, May 15, 2014  Vol. 370 No. 20,1944-1949.

25. Solecito, William A and Johnson Julie, K, 2013, McLaughlin and Kaluzny’ s Continuous Quality Improvement in Healthcare, 4th Edition, Copyright 2013, Jones and Bartlett Publication, Massachusetts; ISBN 13: 978-0-7637-8154-5.

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26. Spath Patrice, Introduction to Quality Health Care Management, 2013, 2nd Edition, AUPHA, Health Administration Press, Chicago, Illinois.

27. Spittal, J.M., et al; The PRONE score: An algorithm for predicting doctors’ risk of formal patient complaints using routinely collected administrative data; BMJ Qual Saf 2015;24:360–368.

28. Studdert,D., Bismark, M., Mello, M., Singh, H., Spittal, M. Prevalence and Chractersitics of Physicians Prone to Malpractice Claims; N Engl J Med 2016;374:354-62.

29. Westover Chad et al, Quality of Care in a Low-Income Consumer-Driven Health Plan: Assessment of Healthcare Effectiveness Data Information Set (HEDIS) Scores for Secondary Prevention Journal for Healthcare Quality, Volume 36, Issue 3, 28-34.

30. Zuger, Abigail ; Hospital Ratings: A guide for the perplexed; JAMA May 19, 2015 Volume 313, Number 19, 1911-1912.

Section 2: Pre 2012- Important and Currently Relevant References:

1. Adams, Karen, Greiner, Ann C., Corrigan, Janet M., Committee on Crossing the Quality Chasm: Next Steps toward a New Health Care System, 2004, 176 pages.

2. Aspden, Philip, Corrigan, Janet M., Wolcott, Julie, Erickson, Shari M., Editors, Committee on Data Standards for Patient Safety; Patient Safety: Achieving a New Standard for Care, 2004, 550 pages

3. Auerbach Andrew D., M.D., M.P.H., The Tension between Needing to Improve Care and Knowing How to Do It N Engl J Med, 357;6, August 9, 2007

4. Benneyan J C, Statistical Process Control as a Tool for Research and Healthcare Improvement, Qual Saf Health Care 2003;12:458–464

5. Berwick Donald, Continuous Improvement as an Ideal in Health Care 1989; New England Journal of Medicine, 320, 1, 53-56

6. Berwick Donald, Payment by Capitation and the Quality of Care- Part 5 (1996) The New England Journal of Medicine, 335,16,1227-1231

7. Blumenthal David, Quality of Care – What is it? – Part I, (1996) The New England Journal of Medicine, 335, 12, 891-894

8. Blumenthal David, The Origins of Quality of Care Debate- Part 4 ( 1996) The New England Journal of Medicine, 335, 15, 1146-1149

9. Brook Robert, McGlynn Elizabeth, Measuring Quality of Care – Part 2, (1996) The New England Journal of Medicine, 335, 13, 966-970

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10. Brown, RN, CPHQ, Janet A., The Healthcare Quality Handbook: A Professional Resource and Study Guide, 2004/2005 Edition (20th edition available after 7/31/05)

11. Budetti, PP; 10 Years beyond the Health Security Act Failure: Subsequent Developments and Persistent Problems. 2004, JAMA; 292: 2000-2006

12. Bush, GW, Ensuring Access to Health Care: The Bush Plan. JAMA, 2004; 292: 2010-2011

13. Chassin Mark, Improving the Quality of Care- Part 3, (1996) The New England Journal of Medicine, 335, 14, 1060-1063

14. Chassin Mark, Hannan Edward and DeBuono Barbara , Benefits and Hazards of Reporting Medical Outcomes Publicly ( 1996) The New England Journal of Medicine, 334,6, 394-398

15. Couch James (Editor), Health Care Quality Management/Improvement Program for the 21st Century, 1991, American College of Physician Executives and American College of Medical Quality.

16. Davies, H. O., Washington, A. Eugene, Health Care Report Cards: Implications for vulnerable patient groups and the organizations providing them care (2002), Journal of Health Politics, Policy and Law, Vol. 27, 379- 399

17. Dlugacz, Yosef D., Alice Greenwood, Andrea Restifo; The Quality Handbook for Health Care Organizations: A Manager's Guide to Tools and Programs ISBN: 0787969214 Pub. Date: March 2004 Series: J-B AHA Press, #131

18. Ellen Nolte and C Martin McKee, Measuring the health of nations: Updating an earlier analysis, Health Affairs, Volume 27, 58-71, 2008.

19. Golub, Robert M, Beyond Mental Mediocrity, JAMA, 2006, 296, 1139-1140

20. Gruen, RL, Pearson, SD, Brennan, TA, Physicians-Citizens-Public Roles and Professional Obligations. JAMA, 2004; 291: 94-98

21. Hagland, Mark, Transformative Quality, 2009, CRC Press, ISBN: 13: 978-1-4200-8492-4

22. Health Employer Data Information Set –HEDIS 2005/2006, Published by NCQA

23. Hersh, W, Health Care Information Technology: Progress and Barriers. JAMA 2004; 292: 2273-2274

24. Iezzoni Lisa, Assessing Quality Using Administrative Data, (1997) Annals of Internal Medicine , 127, 8 (Part 2), 666-674

25. Lighter Donald, E., Advanced Performance Improvement in Health Care-Principles and Methods, 2011, Jones and Bartlett Publishers, ISBN: 13: 978-0-7637-6449-4

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26. Kerry, J., Ensuring Access to Health Care: The Kerry Plan. JAMA, 2004; 292: 2010-2011

27. Landrum, Mary Beth et al, Is spending more always wasteful? The appropriateness of care and outcomes among colorectal cancer patients. Health Affairs, Volume 27, 159-168, 2008

28. Leach, David C, Philibert, Ingrid, High Quality Learning for High Quality Health Care-Getting it Right, JAMA, 2006, 296: 1132-1134

29. Mclaughlin Curtis and Kaluzny Arnold, Continuous Quality Improvement in Health Care, 3rd Edition, 2006, Aspen Publication (Replaced with 4th Edition, See Below under # 35)

30. Neuhauser Duncan, Provost Lloyd, Bergman Bo,The Meaning of Variation to Healthcare Managers …… BMJ Qual Saf, 2011;20(Suppl 1):i36-i40

31. Prevalence of Overweight and Obesity among US Children, Adolescents and Adults, 1999-2002. JAMA, 2004; 291 2847-2850

32. Quality First: Better Healthcare for All Americans, Advisory Commission on Consumer Protection and Quality in the Healthcare Industry (Call 800/732-8200 for your free copy)

33. Ransom, Elizabeth, Joshi, Maulik, S., Nash, David, B., Ransom, Scott, B., The Healthcare Quality Handbook, Second Edition, 2008, ISBN: 978-1-56793-301-7

34. Reschovsky, J, D., Hargraves, J. Lee., and Smith, A. F., Consumer beliefs and health plan performance: It’s not whether you are in an HMO but whether you think you are. ( 2002), Journal of Health Politics, Policy and Law, Vol 27, 353-377

35. Robinson, JC, Reinvention of Health Insurance in the Consumer Era. JAMA, 2004; 291: 1880-1886

36. Robinson, J.C., Slouching towards value based health care. Health Affairs, Volume 27, 11-12, 2008.

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