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The "Toward Excellence in Care" program: a statewide indicator project

J T Lynch1, A S Mattie, I P Shevchenko

  • 1Connecticut Hospital Research and Education Foundation, Inc, Wallingford 06492-0090.

The Joint Commission Journal on Quality Improvement
|November 1, 1993
PubMed
Summary
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The "Toward Excellence in Care" program uses quality indicators to improve patient care. Expanding use reflects progress in data collection, acceptance, risk adjustment, and report understanding.

Area of Science:

  • Health Services Research
  • Quality Improvement Science

Background:

  • The "Toward Excellence in Care" program initiated in 1988 by Connecticut hospitals and physicians.
  • Objective was to develop and implement quality-of-care indicators for healthcare improvement.

Purpose of the Study:

  • To assess the impact and expansion of the "Toward Excellence in Care" program.
  • To identify challenges and progress in healthcare quality improvement initiatives.

Main Methods:

  • Utilized data from the Connecticut Health Information Management and Exchange (CHIME) database.
  • Integrated data from state mortality, trauma registries, and hospital admission/discharge records.
  • Program staff facilitated hospital use of indicator reports for quality improvement.

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Main Results:

  • Analysis of acute myocardial infarction (AMI) patient care identified improvement opportunities.
  • Cardiology and hospitalwide quality improvement teams reviewed 100% of relevant patient charts.
  • Recommended changes included pre-consultation thrombolytic therapy and post-coronary care program modifications.

Conclusions:

  • The program's expanding use indicates progress in overcoming key challenges.
  • Key challenges addressed include data collection burden, information acceptance, risk adjustment, and report clarity.
  • Successful implementation of quality improvement strategies is demonstrated by the program's growth.