1. health and fitness

International Journal for Quality in Health Care
(Formerly Quality Assurance in Health Care)
The Official Journal of the International Society for Quality in Health Care
(ISQua)
Editor-in-Chief: R. H E A T H E R PALMER"
Regional Editors: H E A T H E R BUCHAN
KLAUS PIWERNETZ
BEATRIZ ZURTTA
VOLUME CONTENTS AND AUTHOR INDEX
VOLUME 6 (1994)
Pergamon
International Journal for Quality in Health Care
The Official Journal of the International Society for Quality in Health Care
Editor-in-Chief
R. HEATHER PALMER
Center for Quality Care Research and Education,
Harvard School of Public Health,
677 Huntington Avenue,
Boston, MA 02115
Tel. (1) 617 432 0490; Fax (1) 617 432 0491
Regional Editors
HEATHER BUCHAN
Clinical Policy & Review, Public Health
Branch, Department of Health & Community
Services, 555 Collins St,
Melbourne, Victoria 3001, Australia
Tel. (61) 3 616 7308; Fax (61) 3 616 8383
KLAUS PIWERNETZ
DIABCARE, Ledererstrasse 10,
80331 Munchen, Germany
Tel. (49) 89 297567; Fax (49) 89 298575
BEATRIZ ZURITA
Mexican Foundation for Health, Pcriferico
Sur no 4809, Col. El Arenal, Tepepan,
Tlalpan, 14610, Mexico DF
Tel. (52) 5 655 9011; Fax (52) 5 655 8211
Editorial Committee
Balmain, NSW, Australia
JOHN BEST,
NICK BLACK, London, UK
IRIS BLOMBERO, Stockholm, Sweden
ROBERT BROOK, Santa Monica, CA, USA
BRIAN COLLOPY, East Melbourne, Australia
JANET CORRIGAN, Washington, DC, USA
REUBEN ELDAR, Raanana, Israel
JiNNET FOWLES, Minneapolis, MN, USA
ALEXANDRA GIRAUD, Bondy, France
RICHARD GROL, Nijmegen, The Netherlands
LASZLO GULACSI, Debrecen, Hungary
MAIMUNAH A. HAMID, Kuala Lumpur, Malaysia
WILLIAM JESSEE, Oakbrook Terrace, IL, USA
JOHN KELLY, Chicago, LL, USA
ALISON KITSON, London, UK
ALESSANDRO LIBERATI, Milan, Italy
ANU MACINTOSH, Halifax, Canada
JOAO MEZOMO, S3O Paulo, Brazil
MALGORZATA NABIALCZYK, Boston, MA, USA
DAVID NICHOLAS, Bethesda, MD, USA
FRANCO PERRARO, Udine, Italy
HAYA RUBIN, Baltimore, MD, USA
PEDRO SATURNO, Murcia, Spain
HANS-KONRAD SELBMANN, Tubingen, Germany
YANNIS SKALKIDIS, Athens, Greece
MARCIA STEVIC, Shaker Heights, OH, USA
ROSA SUNOL, Barcelona, Spain
STUART WHITTAKER, Tygerberg, South Africa
Special Project Editor
ROSA SUNOL. Spanish Abstracts
International Journal for Quality in Health Care is
published quarterly in March, June, September and
December. Annual Institutional Subscription Rates
1995: North, Central and South America, U.S.$224,
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of the International Society for Quality in Health
Care (ISQua) receive the journal as part of their
membership dues. Prices are subject to change
without notice.
Whibt every effort is made by the publishers and editorial
board to see that no inaccurate or misleading data, opinion
or statement appears in this journal, they wish to make it
dear that the data and opinions appearing in the articles
and advertisements herein are the sole responsibility of the
contributor or advertiser concerned. Accordingly, the
publishers, the editorial board and editors and their
respective employees, officers and agents accept no
responsibility or liability whatsoever for the consequences
of any such inaccurate or misleading data, opinion or
statement.
Drug and dosage selection: The authors have made every
effort to ensure the accuracy of the information herein,
particularly with regard to drug selection and dose.
However, appropriate information sources should be
consulted, especially for new or unfamiliar drugs or
procedures. It is the responsibility of every practitioner to
evaluate the appropriateness of a particular opinion in the
context of actual clinical situations and with due consideration to new developments.
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Production Editor (Elsevier Science)
MARIA HALE
Copyright © 1994 Elsevier Science Ltd
Ul
CONTENTS
NUMBER 1
Selected Papers Presented at the 10th International ISQA Conference on Quality
Assurance in Health Care
Leading Article
Beyond Maastricht and Scheveningen
E. Reerink
1
Presidential Address
John Best
3
Issues and Challenges in Quality Assurance of Health Care
John W. Williamson
5
Guidelines for Qinical Practice: Applications for Primary Care
Kathleen N. Lohr
17
Quality Assurance in Health Care: Lessons for Others
Yuri M. Komarov
27
Establishing Inter-hospital Comparisons of Outcomes
Robert Cleary
31
Improving the Quality of Anti-emetic Therapy
Kristin Ramm, Signe de Ron, Hroar Piene and Claes Trope
37
Blood Usage Review in a Belgian University Hospital
J. Scoots and L. Steenssens
41
A Method to Measure Quality of Diabetes Treatment: Results from an Outpatient Clinic
S. H. Sand#, C. Hagen and H. Beck-Nielsen
47
Regular Papers
Letter From The President
Enrique Ruelas
57
Leading Article
How D o we Assess "Good Nursing Care"?
Elaine Papps
59
Papers
Improving Regulation of Care
Rachel Fleishman, Gad Mizrachi, Aida Dynla, Dror Walk, Vicky Shirazi and Ayala Shapira
61
Orthopaedic Outpatient Referral Guidelines: Experience in an English Health District
R. Madhok and S. Green
73
Testing a Modified Swedish Version of the Rush Medicus Nursing Process Quality Monitoring
Instrument in Short-term Care
C. Gdtherstrdm, E. Hamrin and J. Carstensen
77
iv
Contents
The Patient's Perspective on Nursing Quality: Developing a Framework for Evaluation
Helena Leino-Kilpi and Jaana Vuorenheimo
85
Laboratory Testing in Primary Health Care in Belgrade
97
Mirjana Zivkovic, Vesna Bjegovid, Sneiana Simic and Jelena Marinkovid
Book Review
103
Society News
105
Announcements
107
Abstractos en este Numero
109
NUMBER 2
Editorial: A Coming of Age
H. Palmer
113
Single and Combined Strategies for Implementing Changes in Primary Care: A Literature
Review
M. Wensing and R. Grol
115
The Quality of Ambulatory-based Primary Care: A Framework and Recommendations
D. R. Longo and A. J. Daugird
133
Managing Patient Discharge to Home: The Challenges of Achieving Quality of Care
C. L. McWHliam and J. F. Sangster
147
Measuring Quality of Care: Fundamental Information from Administrative Datasets
D. W. Garnkk, A. M. Hendrkks and C. B. Comstock
163
Client Flow Analysis: A Practical Management Technique for Outpatient Clinic Settings
P. F. Lynam, T. Smith and J. Dwyer
179
The RAND/AMA/AMCC Clinical Appropriateness Initiative: Insights for Multi-site
Appropriateness Studies Derived from the Abdominal Aortic Aneurysm Surgery Project
187
D.J.Ballard
General Practitioners' Views of Clinical Guidelines for the Management of Asthma
199
D. Armstrong, J. Fry and P. Armstrong
News
203
ISQuaNews
215
NUMBER 3
Editorial
H. Palmer
217
Papers
Concerted Action Programme on Quality Assurance in Hospitals 1990-1993
(COMAC/HSR/QA)
Global Results of the Evaluation
N. Klazinga
219
Contents
v
Appropriateness of Medical Care in Europe: a Commentary
N. Black
231
Variation in Use of Breast Surgery and Characteristics of Hospitals' Surgical Staff
R. Grilli, N. Scorpiglione, A. Nlcolucci, F. Mainini, A. Penna, E. Mari, M. Belfiglio and
A. Llberati
233
Should we Assess Appropriateness of Care in Europe?
F. Paccaud and H. Guillain
239
The Appropriateness of Performing Coronary Angiography in Two Major Teaching Hospitals
in Israel
245
B. Mozes and E. Shabtai
Effect of Panel Composition on Appropriateness Ratings
G. M. Fraser, D. Pilpd, J. KosecotT and R. H. Brook
Implementing Guidelines in General Practice.
Evaluation of Process and Outcome of Care in Chronic Diseases
F. G. Schellevis, J. Tta. M. v Etfk, E. H. vd Lisdonk, J. vd Velden and C. v Wee!
251
257
Measuring Unmet Needs to Assess the Quality of Home Health Care
A. J. E. de Veer and D. H. de Bakker
267
Data Quality in a DRG-Based Information System
C. Colin, R. Ecocbard, F. Delahaye, G. Landrivon, P. Messy, E. Morgon and Y. Matillon
275
Letter to the Editor: Quality in Alternative Medicine — A Rejoinder
P. Tovey
281
Announcements
XII World Congress of the International Society for Quality in Health Care (ISQua)
283
Welcome to St. John's
284
ISQua Conference 1997, Invitation for Proposals
285
News
287
ISQua News
ISQua President's Report
The Eleventh International Conference on Quality in Health Care, 24-28 May 1994: One
Delegate's Perspective
S. Whittaker
289
11th Internationa] ISQua Conference: Prize Winners
295
The International Society for Quality in Health Care Election of Advisory Council
Members —1995
Call for Nominations to Advisory Council
305
Constitution of the International Society for Quality in Health Care (June 1994)
307
Abstractos en este Numero
325
291
vi
Contents
NUMBER 4
Papers
Clinical Indicators as a Stimulus to QA in Hospitals
An Early Report
B. T. Collopy
331
How Case Management Can Improve the Quality of Patient Care
V. D'Addario and A. Curley
339
How Many Days of Hospitalization for an Appendectomy?
E. Martinez-Mas, S. Peiro, R. Meneu, M. L. Rosello-Perez and E. Portella
347
Keeping the Customer Satisfied: Issues in the Interpretation and Use of Patient Satisfaction
Surveys
A. Scott and R. D. Smith
353
Patient Satisfaction with Nursing Care, Evaluation Before and After Cutback in Expenditure and
Intervention at a Surgical Clinic
361
L. Jakobsson, I. R. Hallberg, L. Loven and B. Ottosson
Doctor-Shopping in Hong Kong: Implications for Quality of Care
371
A. Y. Lo, A. J. Hedley, G. K. Pei, S-G. Ong, L-M. Ho, R. Fielding, K-K. Cheng and L. Daniel
Development of Patient Satisfaction Surveys in the Czech Republic: a new Approach to
an Old Theme
H. Kasalova, R. G. Farmer, Z. Roithova and D. Marx
383
Calculation and Administration of Drug Dosage by Swedish Nurses, Student Nurses and
Physicians
I. D. Kapborg
389
Book Review
397
Editorial
399
Announcements
401
News
405
ISQuaNews
411
Editorial Announcement
413
Abstractos en este Numero
417
vu
AUTHOR INDEX
Armstrong, D. 199
Armstrong, P. 199
Hedlcy, A.J. 371
Hendricks, A. M. 163
Bakker, D. R de 267
Ballard,D. J. 187
Beck-Nielsen, R 47
Belfiglio, M. 233
Best,J. 3
Bjegovid, V. 97
Black, N. 231
Brook, R. H. 251
Jakobsson, L. 361
Carstensen, J. 77
Cleary, R. 31
Colin, C. 275
Collopy, B. T. 331
Comstock, C. B. 163
Curley, A. 339
D'Addario, V. 339
Daniel, L. 371
Daugird, A. J. 133
DelahaycF. 275
Dwyer, J. 179
Dynia, A. 61
EcochanLR. 275
Eijk, J. Th. M. v 257
Fanner, R. G. 383
Fielding, R. 371
Fleishman, R. 61
Flon, S. de 37
Fraser, G. M. 251
Fry, J. 199
Garnick, D. W. 163
GOtherstrtm, C 77
Green, S. 73
Grilli,R. 233
GroLR. 115
Girillain, R 239
Hagen,C. 47
Hallberg, I. R. 361
Hamrin, E. 77
Ka-Keung Cheng 371
Kapborg, I. D. 389
Kasalova,H. 383
Klazinga,N. 219
Komarov, Y. M. 27
KosecofE,J. 251
Lai-Ming Ho 371
Landrivon, G. 275
Leino-Kilpi, R 85
Libcrati, A. 233
Lisdonk, E R v d 257
Lo, A.Y. 371
Lohr, K.N. 17
Longo, D. R. 133
Loven,L. 361
Lynam, P. F. 179
Madhok, R. 73
Mainini, F. 233
Mari,E 233
Marinkovid, J. 97
Martinez-Mas, E. 347
Marx,D. 383
Marillon,Y. 275
McWilliam, C. L. 147
Meneu,R. 347
Messy, P. 275
Mizrachi,G. 61
Morgon, E. 275
Mozes,B. 245
Perma, A. 233
Piene,R 37
PilpeLD. 251
Portella,E. 347
Ramm, K. 37
ReerinlcE. 1
Reiley, P. 397
Roithova, Z. 383
Rosello-Perez, M. L. 347
Ruelas,E. 57
Sande, S. R 47
Sangster, J. F. 147
Say-Gark Ong 371
Schellevis, F. G. 257
Schots,J. 41
Scorpiglione, N. 233
Scott, A. 353
Shabtai,E. 245
Shapira, A. 61
Shirazi,V. 61
Simid, S. 97
Smith, R. D. 353
Smith, T. 179
Steenssens, L. 41
Tovey, P. 281
Trope, C. 37
Veer, A. J. E. de 267
Velden, J. vd 257
Vuorenheimo, J. 85
Nicolucci,A. 233
Ottosson, B. 361
Paccaud, F. 239
Palmer, R 113,217
Papps, E. 59
Pei,G. K. 371
Peiro, S. 347
Walk,D. 61
WecLC. v 257
Wensing,M. 115
WhhJaker, S. 291
Williamson, J. W. 5
2ivkovic,M. 97
Printed in Great Britain by Nuffield Press Limited
Selected Papers Presented at the 10th International
ISQA Conference on Quality Assurance in
Health Care
Maastricht, The Netherlands, 21-23 June 1993
Evert Reerink (Guest Editor)
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contributor or advertiser concerned. Accordingly,
the publishers, the editorial board and editors and
their respective employees, officers and agents
accept no responsibility or liability whatsoever for
the consequences of any such inaccurate or misleading data, opinion or statement.
Drug and dosage selection: The authors have made
every effort to ensure the accuracy of the information herein, particularly with regard to drug
selection and dose. However, appropriate information sources should be consulted, especially for
new or unfamiliar drugs or procedures. It is the
responsibility of every practitioner to evaluate the
appropriateness of a particular opinion in the
context of actual clinical situations and with due
consideration to new developments.
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Contents
Selected Papers Presented at the 10th International ISQA Conference on Quality
Assurance in Health Care
Leading Article
Beyond Maastricht and Scheveningen
1
E. Reerink
Presidential Address
3
John Best
Issues and Challenges in Quality Assurance of Health Care
John W. Williamson
Guidelines for Clinical Practice: Applications for Primary Care
5
17
Kathleen N. Lohr
Quality Assurance in Health Care: Lessons for Others
Yuri M. Komarov
27
Establishing Inter-hospital Comparisons of Outcomes
31
Robert Cleary
Improving the Quality of Anti-emetic Therapy
Kristin Ramm, Signe de Flon, Hroar Piene and Claes Trope
37
Blood Usage Review in a Belgian University Hospital
J. Schots and L. Steenssens
41
A Method to Measure Quality of Diabetes Treatment: Results from an Outpatient Clinic
S. H. Sand0, C. Hagen and H. Beck-Nielsen
47
Regular Papers
Letter From The President
57
Enrique Ruelas
Leading Article
How Do we Assess "Good Nursing Care"?
59
Elaine Papps
Papers
Improving Regulation of Care
61
Rachel Fleishman, Gad Mizrachi, Aida Dynia, Dror Walk, Vicky Shirad and Ayala Shapira
Orthopaedic Outpatient Referral Guidelines: Experience in an English Health District
R. Madhok and S. Green
ui
73
iv
Contents
Testing a Modified Swedish Version of the Rush Medicus Nursing Process Quality Monitoring
Instrument in Short-term Care
77
C. Gotherstrdm, E. Hamrin and J. Carstensen
The Patient's Perspective on Nursing Quality: Developing a Framework for Evaluation
85
Helena Leino-Kilpi and Jaana Vuorenheimo
Laboratory Testing in Primary Health Care in Belgrade
97
Mirjana Zivkovil, Vesna Bjegovid, Sneiana Simid and Jelena Marinkovic
Book Review
103
Society News
105
Announcements
107
Abstractos en este Numero
109