Objectives: Understand innovation in outpatient safety management, eg, avoiding late diagnosis of cancers.
Study Design: Qualitative data from managers in 23 large organizations identified as innovators used to create model of how capitation and other external factors motivate injury prevention, organizational processes changes, and internal organizational factors influencing extent of innovation.
Population Studied: Large physician groups and environment
Principal Findings and Conclusions: Organizations varied greatly in innovation. Innovations included systems to: identify and analyze errors and injuries; prioritize and specify process changes; implement specific changes; and monitor for compliance and further improvement. Key external influences were liability risk, market competition, and professional concern for quality. Fiscal and Regulatory incentives occasionally were influential.
The most important internal influence was managerial talent and organizational experience, forms of intellectual capital built up through prior efforts to manage clinical and administrative processes in response to capitation, other managed care.
Implications: Much greater measurement and reporting outcomes including injuries is needed, further model testing now appropriate.
Learning Objectives: At the conclusion of the session, participants will be able to: identify the types of patient injury at issue in current policy discussions about patient protection, patient safety, and medical error, particularly in the outpatient setting. understand some of what is known about the factors underlying injry and promoting or inhibiting efforts at prevention articulate the policy options available -- public and private, legal and other -- to ameliorate medical injuries understand the emerging state of evidence about errors, injury and prevention. identify the relative strengths and weaknesses of differing approaches consider whether their career or their research can make a contribution to improving such outcomes
Keywords: Health Law, Injury Prevention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.