|
||
SECTION 1. Introduction
| SECTION 1 INTRODUCTION PURPOSE OF THIS MANUAL This manual has been written to describe the UAB ABC system to the wide range of persons who are charged with improving quality of health care. In addition, we have a purpose other than simply to introduce a new measurement tool. Research on the ABC methodology is continuing at UAB. It is hoped that the manual will stimulate additional use and the interchange of experiences and suggestions for the methods' improvement and wider clinical application. We are cognizant that many questions remain to be answered, and we encourage practitioners and academics to join us in enhancing the ABC methodology.
WHAT IS THE UAB ABC™ SYSTEM? Benchmark performance is measured by the proportion of patients for whom certain clinical processes of care are prescribed or recommended. These processes of care are considered to be indicators (a term used frequently in the ABC method) and their usage indicates differing degrees of excellent care giving. An indicator might, for example, be a recommendation that all post-MI patients take aspirin therapy. The indicator measure for doctor A or hospital Y is the proportion of clinically appropriate patients to whom this recommendation is actually made. In its benchmark calculation, the ABC system ranks comparable providers and computes statistics that can be used as feedback to individual providers to measure their progress towards health care excellence in relation to that of their "best in class" peers. WHO CAN BENEFIT The ultimate beneficiary of course is the patient. The ABC method can be used by providers, insurers or government agencies in a wide range of settings, including hospitals, physician practices, nursing homes, public health clinics, or managed care organizations. ABCs can be applied to groups of community providers, to institutions or departments within them, or to individual practitioners. We firmly believe that if ABCs are used to improve the rates of usage of processes of care known to improve outcomes, a higher proportion of patients and their families will benefit by receiving the "best" care. This, in turn, will benefit those responsible for paying for the nation's health care by leading to a healthier population and ultimately reducing the cost of care. WHAT IS NEEDED IN ORDER TO USE THE ABC™ SYSTEM? WHAT TYPE OF DATA ARE NEEDED? Data to calculate usage rates of selected processes of care must include information that provides both the denominator - the numbers of patients for whom the intervention is appropriate, and the numerator - the number of patients actually receiving the intervention. Data can be obtained from: · the internal information systems of provider organizations such as hospitals, clinics, nursing homes, home healthcare agencies, or laboratories. Data could be in medical records, financial, administrative or clinical information systems already in place to provide daily internal management, billing and decision support information. · managed care organizations' administrative and claims records, or, · public data bases, e.g., the National Health Interview Survey, Medicare claims reports. Lists of processes and outcome indicators can be obtained from AHRQ's CONQUEST database. References to literature to support these are also available. More information can be obtained at www.ahrq.gov. HAVE ABCs BEEN TESTED? Yes. With support from CMS, AHRQ and AQAF, the ABC method has been developed and tested under everyday, clinical conditions. It has been successfully applied in a variety of situations, e.g., management of diabetes mellitus, treatment of post MI patients, and utilization of mammography and pap smear screening. (See Bibliography) DOES THE ABC™ METHOD HAVE ADVANTAGES OVER OTHER METHODS? |
 |
|