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|a 9780727918338
|9 978-0-7279-1833-8
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|a (DE-627)72262980X
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|a eng
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|a RJ253.5 .S38 2009
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|a 618.9201
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|a Schulman, Joseph
|e verfasserin
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|a Evaluating the Processes of Neonatal Intensive Care
|b Thinking Upstream to Improve Downstream Outcomes
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|a Hoboken
|b Blackwell Publishing Ltd
|c 2008
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|a Online-Ressource (160 p.)
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|a Text
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|a Description based upon print version of record
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|a Evaluating the Processes of Neonatal Intensive Care; Evaluating the Processes of Neonatal Intensive Care; Contents; Preface; References; Introduction; We don't work alone; Work standards; Three core questions; Probing the variation among providers; "drilling down" in our work; What is quality?; How we will approach quality improvement?; Lessons from Japan about quality and cost; A view of the work of the NICU; The plan of this book; My commitment to you; References; 1: Systems and our work; Our usual way of thinking (typical, linear thinking); Thinking about interrelationships
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|a Operational definitionsSystems; System aims; How do we know we are meeting our aims?; System optimization: don't mistake a part for the whole; Work as a system; Interrelationships within a system; System boundaries and system perspectives; Key ideas about systems from Senge's rules of the "fifth discipline"; Reconciling a single, isolated cause with systems thinking; References; 2: The work of the NICU; Processes: general understanding; Processes: getting to the core of the work; Process mapping; Analyzing a process map; Customers; Customer knowledge
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|a Matching the service with the customer needProcess inputs; Suppliers; Vision: seeing the bigger picture; The improvement plan: identify the performance gaps, look for leverage points, "design and redesign"1; References; 3: Working with process mapping: an example; A process for identifying and treating acute pneumothorax; Further suggestions by NICU staff for improvement; If process ownership is not assigned, there may be no real process; 4: Activity without value: muda; Activity without value: a systems framing; Mudaand some assumptions about efficiency and waste
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|a Ideas for where to begin looking for mudain the NICUIdeas for reducing muda; "Drilling down" to reduce muda; References; 5: Diagnostic testing and muda; A Bayesian search for muda in diagnostic testing; Maybe this way is more intuitive; To evaluate the results of a diagnostic test we need specific disease knowledge; Overtreating: a plea for locally determined test characteristics; The receiver operating characteristic (ROC) curve: diagnostic tests and categorical discrimination; Recapping; References; 6: Needless complexity in our care processes
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|a How needless complexity compounds to undermine process reliabilityReference; 7: More tools for "drilling down"; Reiterative tests of change: the PDCA cycle; Cause and effect diagram: formulating a "differential diagnosis" for an outcome; Pareto charting; The run chart: preserving the time dimension; References; 8: Measuring outcomes: What? How?; Toward an operational definition of "outcomes research"; What do we want to measure? Well, what question are we asking?; The clinical value compass and NICU outcomes; Tips for creating variables to measure
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|a Investigative perspective and outcome interpretation
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|a An essential guide for evaluating outcomes and improving practice in the neonatal intensive care unit - an aspect of neonatal intensive care that is not covered in standard texts. Written by a neonatologist with experience in outcomes research, the book engages Neonatal Intensive Care Unit (NICU) workers with vitally important questions about their work: What is a good NICU?Could you achieve better results? How completely can you characterize the results of your NICU?
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