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NeoReviews Vol.5 No.2 2004 e33
© 2004 American Academy of Pediatrics

Quality Improvement in Perinatal Medicine

Assessing the Quality of Perinatal Care

^* Professor of Pediatrics; Director, Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatal and Developmental Medicine, Stanford University Medical Center, Palo Alto, CA

The first 300 words of the full text of this article appear below.

	Objectives

 
After completing this article, readers should be able to:

1. List four processes of concern for quality improvement.
   
2. Provide an example of a structural feature that can affect neonatal outcome.
   
3. Describe a process indicator that is related to neonatal outcome.
   
4. Define case mix and its use in quality assessment.
   
5. List the separate advantages of using process and outcome measures.
   

	Definition of Quality Medical Care

 
The issue of quality health care has achieved growing prominence over the last 2 decades. (1)(2)(3)(4)(5) The public reporting of "quality"; the use of quality as an important factor in negotiating care contracts; and activities to improve the quality of care at the practitioner, managed care organization, and hospital levels are now widespread and constitute what has been labeled the "quality revolution." (6)(7)

The Institute of Medicine (IOM) defines quality as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." (8) This definition has been widely accepted because it speaks to a broad spectrum of stakeholders. The inclusion of individuals and populations addresses concerns that range from the clinical care of individual patients to population initiatives to improve socioeconomic and racial disparities in accessibility to and the quality of both preventive and curative health care. (9) The concept of desired health outcomes includes the desires of the patient to participate in and be satisfied with the medical decision making process as well as the desires of corporate and governmental payers to obtain value for their health dollars. (10) The inclusion of current professional knowledge emphasizes both the role of evidence-based medicine and the obligation for effective continuing education. Although the discussion of quality is as broad as . . . [Full Text of this Article]

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This article has been cited by other articles:

				T. N.K. Raju, R. L. Ariagno, R. Higgins, and L. J. V. Marter Research in Neonatology for the 21st Century: Executive Summary of the National Institute of Child Health and Human Development-American Academy of Pediatrics Workshop. Part I: Academic Issues Pediatrics, February 1, 2005; 115(2): 468 - 474. [Abstract] [Full Text] [PDF]