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California State University, Long Beach

Health Care Administration Program

HCA 450-02 - Quality Management/Improvement in Health Care Delivery

Semester FALL 2015

Instructor: Rus Billimoria, MD, MPH, CPHQ

Office Hours: Tuesdays 6 - 7 pm

(Please call for appointments.

Telephonic appointments also available

at other prearranged days and times)

Phone: (818) 844 8003

Cell: (310) 508 1472

Class Number: Section 02, 6062 (HCA 450)

Class Location: SPA, Room-105

Class Meets: – August 24, 2015

Tuesdays from 7 PM to 9:45 PM

Additional Contact Information:

HCA Program Administrative Coordinator: Deby McGill,

Tel. 562/985-5694; fax 562/985-5886

Catalog Description

Prerequisites: HCA 300. (Please refer to details below) and HCA 465 (Preferred)

Basic elements of quality improvement and organizational responsibilities related to quality improvement in health care delivery. Data analysis for quality improvement, clinical practice guidelines, and future of healthcare quality improvement strategies.

Letter grade only (A-F). (Lecture)

ADA Accommodation will be provided to any student who requests such, as defined by the ADA act and CSU-LB. Please contact Dr. Billimoria or refer to your student handbook for further information.
Note: This syllabus is subject to change. Should there be any changes; students will be notified in class of the amendments.


For HCA 450 students: Prior to attending this course students are required to complete the following courses:

  • HCA 300 (Health Care System) and

  • HCA 465 (Analysis and Evaluation)

The purpose of this course is to familiarize the student with the concept of Quality and the process of Quality Improvement across the Health Care continuum. This course focuses on the history and evolution of quality, its terms, principles, theories, and practices. The student is introduced to a diverse collection of methods of improving quality, including but not limited to continuous Quality Improvement and Total Quality Management, and to the guidelines for implementing quality management and the continuous quality improvement processes. Additionally , the students will be asked to review the changes that a selected number of health care systems from across America have implemented in order to achieve the Institute of Medicine’s goals to make quality health care more safe, timely, effective, equitable, efficient, and patient-centered. Students will also be exposed to new cutting edge technologies that impact the quality improvement efforts/interventions in health care delivery.
Learning Objectives, Domain and Competency Table

Learning Objective



Activity (A1), Assignment (A2) or Assessment (A3)

Understand and evaluate the implications and effects of regulation, legislation and accreditation to Health Care Quality Improvement

Knowledge of the Healthcare Environment

Regulatory and administrative environment in which the organization functions (e.g., antitrust; Stark I and II; accreditation; organized labor)

Lecture, Short Essay

And Class Discussion

Understand and discuss Quality, Efficiency, Return on Investment, Access to health care and Quality implications

Knowledge of the Healthcare Environment

The interrelationships among access, quality, cost, resource allocation, accountability, and community

Lecture, Discussions, Project & Paper

Discuss, Understand Customer Satisfaction- Six Sigma, Lean Sigma, Taguchi Loss function theories

Knowledge of the Healthcare Environment

The patient perspective

Lecture, Discussions, Project and Case studies

Understand, discuss Incentive payments for Quality Health Care

Knowledge of the Healthcare Environment

Funding and payment mechanisms of the healthcare system

Lecture, Discussions, Paper or classroom projects

Understand the need for Accreditation, accreditation standards, and impact of Accreditation to Quality

Knowledge of the Healthcare Environment

Governmental, regulatory, professional, and accreditation agencies (e.g., CMS; JC; NCQA) related to healthcare delivery

Lecture, Discussion

Understand and analyze New Technologies and Quality Implications

Knowledge of the Healthcare Environment

Healthcare technological research and advancements

Lecture, Discussion

Understand and Discuss Quality Improvement in various delivery systems

Knowledge of the Healthcare Environment

Organization and delivery of healthcare (e.g., acute care, ambulatory care, medical practice, ancillary services)

Lecture, Discussion, Project

Use Statistical Tools and Analysis for Quality Improvement

Business Knowledge and Skills

Basic statistical analysis

Lecture, Classroom project

Use Clinical Guidelines, Benchmarks in Quality Improvement

Business Knowledge and Skills

Evidence-based practice

Lecture and Discussion

Use Predictive Modeling for Decision Support

Business Knowledge and Skills: D. Strategic Planning and Marketing

Characteristics of strategic decision support (e.g., planning; marketing; modeling; forecasting)

Lecture, Discussion

Developing a Quality Imrovement Program-Mission,Vision,Goals, Objectives. Aligning Quality Improvement with organizational strategic plan

Business Knowledge and Skills: D. Strategic Planning and Marketing

Organizational mission, vision, objectives and priorities

Lecture, Discussion and Project

Evaluate the benefits of Electronic Health Records, E-Prescribing and improvement of safety and quality-Regional Extension Centers and the Federal Stimulus for HIT

Business Knowledge and Skills: E. Information Management

Physician practice management IT systems (e.g., billing; referral/authorization; claims processing; electronic medical records; prescription writing; productivity; transcription)

Guest Lecture, Discussions, Position Paper Optional

Discuss Credentialing Requirements as a structural component for Quality Improvement

Business Knowledge and Skills: F. Risk Management

Credentialing, medical malpractice, and professional liability

Lecture, Discussion

Discuss and Analyze Detailed Theories, Principles of TQM, CQI, Deming, Juran, Crosby etc-

Business Knowledge and Skills: G. Quality Improvement

Quality improvement theories and frameworks

Lecture, Discussion, Paper, Project

Discuss, analyze concepts and applications of Six Sigma and Lean (Industry Model and Relevance to Healthcare)

Business Knowledge and Skills: G. Quality Improvement

Quality improvement theories and frameworks

Lecture, Discussion, Paper, Project

Develop strategy for Quality Planning and management

Business Knowledge and Skills: G. Quality Improvement

Quality planning and management

Lecture and Classroom Project

Calculate Utilization Metrics and Relative Resource Use. Understand Quality Implications of Under Over Utilization and Medical Loss Ratio (MLR)

Business Knowledge and Skills: G. Quality Improvement

Utilization review and management regulations

Lecture, Discussion, Classroom Project


Upon completion of this course, the student will be able to:

  1. Describe the evolution of the health care systems and Quality Management/Improvement Programs and reflect on its future.

  1. Understand the reasoning and the importance of the requirements for Health Care Quality

Management/Improvement Programs.

  1. Describe the most current Quality Management/Improvement Program principles and techniques for health care in general. This includes the principles of Continuous Quality Improvement, Total Quality Management, and proactive versus reactive Quality Management programs.

  1. Understand use of Quality Improvement Tools and Strategies including Kaizen, Lean and Six Sigma.

  1. Understand the impact of federal and state legislation on Quality Management/Improvement Programs in Health care.

  1. Understand the need for and development of standards for accreditation of health care entities.

  1. Describe the recent impact of consumers on health care Quality Management/Improvement Programs and the development of health plan Report Cards (HEDIS etc.).

  1. Understand the use of data and statistics for an effective Quality Management/Improvement Program.

  1. Understand basic elements of provider credentialing, physician profiling and report cards, risk management and liability issues as they relate to Quality Management/Improvement Programs.

  1. Understand the effect of Patient Safety issues on Quality Management/Improvement systems.

  1. Understand the recent trends in Quality Management/Improvement and Continuous Quality and Continuity of Care issues in Assisted Living, Skilled Nursing, and Long Term Care.

  1. Health Care Report Cards, Pay For Performance and other strategies used for improving the quality of health care

  1. Demonstrate understanding of the principles in the development of a Quality Management/Improvement Program/Project and Strategies for a health care entity via successful completion of class project.



This course does not prescribe a specific text, since no single text would cover the broad scope of this course. However, the following books and materials are strongly recommended for review:

  1. Introduction to Quality Health Care Management, Patrice Spath, 2013, 2nd Edition, AUPHA, Health Administration Press, Chicago, Illinois

Lecture notes and handout materials. All lecture notes will be posted on Beach Board. Students need to print these. Some copies may be available for distribution by the instructor.

I Short Essays (Approx. 10% of overall class Grade for each one of 2 essays over the course of the semester. Total Percentage of overall class grade for these 2 essays is 20)

To understand the latest trends around Quality Management/Improvement Programs it is necessary to review articles related to health care quality from various sources including professional medical or health care journals. Students will be expected to write short essays on specific prescribed topics (a maximum of two, doubled spaced typed pages with a reasonable font size 11 or 12 ). The students will be provided with a relevant topic for each essay. Students will then research and select one or more published articles pertaining to the topic and complete the short essay as follows:

  1. Introduction – Introduce the topic with a brief reason for selecting the article(s) or sources used for the essay. Students must make special mention in support for selecting their articles.

  2. Summary-Summarize the contents of the article(s) as they relate to the topic.

  3. Discussion-Provide your analysis and discussion pertaining the topic being discussed.

  4. Conclusions – Conclusion regarding the topic derived from the article(s).

The essays will be graded on a scale of (0 – 20 points). Grading will be based on the contents of sections addressed above.

Examples of Journals that may be used for writing your essays are as follows:

  1. Journal of the American Medical Association (JAMA) -

  2. New England Journal of Medicine -

  3. Annals of Internal Medicine -

  4. Journal of Health Politics, Policy and Law -

  5. Journal of HealthCare Quality -

  6. Med Bio World - Hospital & Healthcare Management Journals -

The two short essays will be due in the weeks assigned. Please see agenda on the following pages for due dates.

On the due date, submit one copy to the instructor. The essay will be returned after review and scoring.
II Class Participation (Approx. 10% of Overall Class Grade)
Active classroom participation is encouraged. Each student will have adequate opportunities to participate in classroom discussions. Students will be provided the opportunity to participate in small projects and pop quizzes to assess participation. Level of participation will contribute towards the overall course grade.
III Mid Term Exam for HCA 450 (Constitutes approx. 30% of the Overall Class Grade)
HCA 450 students will be administered a midterm exam worth approximately 30% of the overall class grade. The exam will comprise of multiple questions. Questions will be a mix of essay type discussions and short problems based on case studies using the knowledge from topics discussed in class and the prescribed text book during the semester and a series of short case studies or notes on specific issues or topics.
For each essay question, the student will be required to use the following format:

  1. An Introduction to address the case or problem presented

  2. Presentation of the ideas in addressing the issue or case using information from the course.

  3. Brief Discussion of the interventions or direction suggested by the student for addressing the case or issue

  4. Conclusion- Summary of thoughts

Length of the written answer is left to the discretion of the student. It is important to ensure that the above four points be taken into consideration for a complete answer. In general two type written pages with a reasonable font size (11 or 12) would be adequate.

IV PROJECT: Quality Management/Improvement Project or Program Development (Approx. 30% of the overall Grade)
A major classroom project will be the development of a Quality Management/Improvement Program or Quality Improvement Project or Process/strategy pertaining to a health care entity. This project will be assigned during the course and will be completed as part of your final exam. Students will select a topic for the project and discuss with instructor before starting.
Students will form teams and develop a Quality Management/Improvement Program or Process Improvement strategy based topic pertaining to improvement of care and/or services for their selected entity. The project will make use of quality improvement principles and information presented during the course. Each student within a team must make specific contributions to the program or project development and discussions.
The projects developed will be presented to the class by all members of each team. Each team member presents their specific contributions to the project. Please see course agenda below for day of presentation. Guest speakers may be present during presentations and will contribute to the discussions and grading.
Grading Components For “The Quality Management/Improvement Program Strategy Project" (Constitutes approximately 30% of the overall class grade):
I Class Presentation by Team (The score achieved by the team will be applied to each team member)
II Short Project Paper by Each Student: In addition to the presentation, each student’s contribution towards the team project will be presented in form of a paper not less than two double-spaced type written pages. The paper shall comprise of the following elements:

  1. Introduction: The importance of portion being contributed by the student.

  2. Presentation of the ideas and components the student is responsible for developing as part of the team effort

  3. Discussion on the student’s contribution towards the team project using the principles and theories discussed in class as well as pertinent literature reviewed by the student.

III Presentation Scoring Rubric will consider the following:

All 7 Elements listed below must be covered in your Presentation

  1. Outline the research documenting need for healthcare improvement (Background)

  2. Define the system in which you are making improvements (Hospital, HMO,SNF or other entity)

  3. Identify key themes for improvement efforts (Which areas or items of the issue were selected for improvement and why)

  4. Use the improvement processes best suited for your project. (Six Sigma, Lean, PDSA etc)

  5. Develop and Describe the team meeting management skills used to accomplish your project. (Includes Team Dynamics)

  6. Describe basic steps used in managing change as you implemented your improvement plan

  7. Describe the value and context for the tools your team used and implemented in settings you used. Examples include but are not limited to:

  • Fishbones

  • Process mapping

  • Flow charting

  • Run/control charts

The Final Exam Grade for each student includes a combination of the individual student contribution paper and team presentation scores.
Instructor will always be available to all students for guidance during development of the project.
V Comprehensive QUIZ (Approx. 10 % of overall grade): One Comprehensive Quiz will be offered during the semester. This will be announced a week prior to each quiz giving adequate preparation time to the students.

AGENDA AND SEQUENCE OF ASSIGNMENTS (The agenda is subject to change.)
Week Objective

Week 1 – August 25 a) Introduction to the course.

b) Literature Review Guidelines.

c) Introduction to Terminologies.

d) Introduction to Health Care Systems

  1. Selection of Teams (8) & Team Leaders for projects.

Week 2 – September 1 a) Evolution of Health Care Quality Management with a

historic perspective.

b) Introduction to Quality Improvement (Lecture Notes)

c) Discuss Quality Improvement Project

Readings: Review Chapters 1 (Prescribed Text Book)- Defining Quality, What is Quality?

Business Case for Quality – Reading for class project

Week 3 – September 8 a) Basic Elements of Quality Improvement (Lecture Notes)

b) The Deming approach to Quality Improvement.

c) Continuous Quality Improvement (CQI) and

Total Quality Management (TQM) (Thoughts, Lecture notes)

d) Classroom Project-Business case for Quality

Readings: Chapter 2 (Prescribed), Quality Building Blocks

Week 4 – September 15 Topic for Essay # 1 to be announced in class

a) Continuous Quality Improvement –Thoughts (Lecture Notes)

b) Beyond Ishikawa (Lecture Notes)

c) Data and Measuring Performance

Review: Chapter 3 (Measuring Performance)

Essay # 1 to be submitted in class

Week 5 – September 22 a) Performance Improvement Tools for Quality- Introduction with Fishbone Diagram (Lecture Notes)

b) Discuss FOCUS and Pareto Charts (Lecture notes)

c) Leadership and Quality Improvement Teams (Lecture notes)

d) Draw Fishbone- in class exercise

Review: Chapter 6 (Performance Improvement Tools) and Chapter 7 (Improvement Project Teams)

Week 6 – September 29 a) Progress Report and Updates on the Quality Improvement

project by each team.

b) Variations (Lecture Notes)

c) Plan Do Study Act (Using more Tools)

Review: Chapters 4 (Page 100) and Chapter 5 (Continuous improvement)


Topic for Essay # 2 to be announced in class

Week 7 –October 6

  1. Principles and Tools for Quality Part I (Lecture Notes)

  2. Control Charts

  3. Using Quality Improvement Tools- Small Classroom Project

Review: Chapter 6 (Performance improvement Tools)

Week 8 – October 13 a) Principles and Tools for Quality Part II (Lecture Notes)

b) Using Quality Improvement Tools- Small Classroom Project

Review: Chapter 6 (Performance improvement Tools)
Essay # 2 to be submitted in class

Week 9 – October 20 a) Six Sigma and Lean

b) Small Classroom Project Presentations by Teams

Review: Chapter 6 (Six Sigma)
Review: Chapter 4

Week 10 – October 27 a) Customer Service and Quality

  1. Understanding Regulatory Requirements (Guest Lecturer)

  2. Health care Quality and Long Term care (Guest Lecturer)

Review: Chapter 8 (Prescribed Text Book), Lecture Notes

Return Mid Term Papers in Class
Week 11 – November 3 a) Long Term Care and Quality – Guest Lecture

b) Quality Improvement Class Project

Week 12 – November 10 GUEST LECTURE- Obama care and Quality

Week 13 – November 17 Prepare For Finals Project

  1. Medicare Star Program

  2. Health Information Technology, Information Management (Guest Lecture?)

  3. Disease Management Programs

  4. Chronic Care Improvement Programs/Care Management

November 23 – November 25 FALL BREAK

Week 14 – December 1

  1. Accreditations

  2. Safety and Quality

  3. Leap Frog

Week 15 – December 8 FINAL EXAM / PRESENTATIONS- Part I (4 Teams to Present)

  1. Group Presentations of Quality Improvement Projects

  2. Students to submit their individual written project reports

Week 16 – December 15 FINAL EXAM / PRESENTATIONS- Part II (4 Remaining Teams to Present)

  1. Course Summary

  2. The Future of Health Care Quality

  3. Job opportunities in Quality Improvement

  4. Wrap Up

This being a double numbered course, university policy requires greater expectations, additional work and different grading scales for graduate students. Due importance will be given to student participation in projects, papers, class work and exams. Letter Grades are assigned from A-F for level of achievement in the course. For final computation of the letter grades, following weights for each course component will be used:

Component HCA 450

Percent of Grade

Short Essays:





Comprehensive QUIZ


Mid Term Exam Paper


Final Exam

Development of a Quality Management Program Project


Class Participation (Including Attendance and at least two in class projects)





Students are required to attend and to be prepared for each session by reading any assigned or referenced materials. Attendance is expected at each class session. However, if there are compelling circumstances, an absence may be excused. It then becomes the responsibility of the student to bring her/himself up to date with the class material. Please notify the lecturer of any absenteeism either in advance if preplanned or after the fact if due to emergent situations. More than two absences during the semester will impact the class participation score adversely.

It is the responsibility of the student to file for a drop status if he or she desires. No drops will be signed by the instructor after the third week.

A traditional grading system is required for evaluation of student performance in this course. There will be one mid-term and one final exam. Exam formats will be developed and announced by the Instructor. No make-up exams will be offered unless the student has made specific arrangements with the instructor prior to the exam.
Student Course Evaluation
Students will have an opportunity to evaluate this course. Feedback from students is very important and is considered critical to improving this course.

America’s Health Insurance Plans

American College of Medical Quality

American Health Information Management Association

American Health Information Management Association

American Healthcare Association

American Society for Healthcare Risk Management

American Society For Healthcare Risk Management

Association for Quality

association for quality

California Association for Healthcare Quality

California Code of Regulations

California Department of Corporations

California Medical Association

Joint Commission on Accreditation of Healthcare Organizations


National Guideline Clearinghouse

National Library of Medicine

National Network of Libraries of Medicine

Quality Indicator Project



The following is excerpted from the California State University, Long Beach Policy Statement 85-19, dated December 13, 1985.

It is the policy of the faculty and administration to deal effectively with the student who practices cheating or plagiarism. These acts are fundamentally destructive of the process of education and the confident evaluation of a student's mastery over a subject. A University maintains respect and functions successfully within the larger community when its reputation is built on honesty. Similarly, each student benefits in helping to maintain the integrity of the University. This policy, therefore, provides for a variety of faculty actions including those, which may lead to the assignment of a failing grade for a course and for administrative actions, which may lead to dismissal from the University. It is the intent to support the traditional values that students are on their honor to perform their academic duties in an ethical manner.

The following definitions of cheating and plagiarism shall apply to all work submitted by a student.
Plagiarism is defined as the act of using the ideas or work of another person or persons as if they were one’s own, without giving credit to the source. Such an act is not plagiarism if it is ascertained that the ideas were arrived at through independent reasoning or logic or where the thought or idea is common knowledge.
Acknowledge of an original author or source must be made through appropriate references, i.e., quotation marks, footnotes, or commentary. Examples of plagiarism include, but are not limited to, the following: the submission of a work, either in part or in whole, completed by another; failure to give credit for ideas, statements, facts or conclusions with rightfully belong to another; in written work, failure to use quotation marks when quoting directly from another, whether it be a paragraph, a sentence, or even a part thereof; close and lengthy paraphrasing of another writing or paraphrasing should consult the instructor.
Students are cautioned that, in conducting their research, they should prepare their notes by (a) either quoting material exactly (using quotation marks) at the time they take notes from a source; or (b) departing completely from the language used in the source, putting the material into their own words. In this way, when the material is used in the paper or project, the student can avoid plagiarism resulting from verbatim use of notes. Both quoted and paraphrased materials must be given proper citations.

Cheating is defined as the act of obtaining or attempting to obtain or aiding another to obtain academic credit for work by the use of any dishonest, deceptive or fraudulent means.
Examples of cheating during an examination would include, but not be limited to the following: copying, either in part or in wholes, from another test or examination; discussion of answers or ideas relating to the answers on an examination or test unless such discussion is specifically authorized by the instructor; giving or receiving copies of an exam without the permission of the instructor; using or displaying notes; "cheat sheets," or other information or devices inappropriate to the prescribed test conditions, as when the test of competence includes a test of unassisted recall of information, skill, or procedure; allowing someone other than the officially enrolled student to represent the same. Also included is plagiarism, which is defined as altering or interfering with the grading procedures.
It is often appropriate for students to study together or to work in teams on projects. However, such students should be careful to avoid use of unauthorized assistance, and to avoid any implication of cheating, by such means as sitting apart from one another in examinations, presenting the work in a manner which clearly indicates the effort of each individual, or such other method as is appropriate to the particular course.
One or more of the following academic actions are available and may be invoked by the faculty member who finds a student has been cheating or plagiarizing.

  1. Review -- no action.

  2. An oral reprimand with emphasis on counseling toward prevention of further occurrences;

  3. A requirement that the work be repeated;

  4. Assignment of a score of zero (0) for the specific demonstration of competence, resulting in the proportional reduction of final course grade;

  5. Assignment of a failing final grade;

  6. Referral to the Office of Judicial Affairs for possible probation, suspension, or expulsion

In addition students may refer to the following website for information.

Commitment to Inclusion

California State University, Long Beach is committed to maintaining an inclusive learning community that values diversity and fosters mutual respect.  All students have the right to participate fully in university programs and activities free from discrimination, harassment, sexual violence, and retaliation.  Students who believe they have been subjected to discrimination, harassment, sexual violence, or retaliation on the basis of a protected status such as age, disability, gender, gender identity/expression, sexual orientation, race, color, ethnicity, religion, national origin, veteran/veteran status or any other status protected by law, should contact the Office of Equity and Diversity at (562) 985-8256, University Student Union (USU) Suite 301,       

Additional information resources
Students interested in acquiring more information on the university syllabus policy please go to the Faculty Center for Professional Development website at:

The faculty handbook can also be found online at the following link:


For convenience, Course Bibliography is presented in two sections. Section 1 includes published articles over the past 3 years (2012-2015) that are most relevant to this course. Lectures include information from these readings. Section 2 includes older published literature that is currently relevant and includes many a classic writing that continues to be included in current teachings. For both sections, the references are organized alphabetically by last name of primary author.

Section 1: 2012-2015

  1. Davies, S. et al, Impact of including Readmissions for qualifying events in the patient safety indicators; American Journal of Medical Quality 2015, Vol. 30(2) 114–118.

  1. Frist, William H., Connected Health and rise Of the Patient-Consumer, Health Affairs, 33, no.2 (2014):191-193.

  1. Gallagher, Thomas H and Mazor Kathleen, M; Taking Complaints Seriously: using the patient safety lens, BMJ Qual Saf 2015; 24:352–355.

  1. Graber, Mark I, et al, JAMA, September 26, 2012—Vol 308, No. 12, 1211-1212.

  1. Harder, B., Comarow, A., Hospital Quality Reporting by US News and World report: Why, How and What’s Ahead, JAMA May 19, 2015 Volume 313, Number 19; 1903-1904

  1. Hebert, Philip C, Disclosure after large scale events: Price of honesty? BMJ Qual Saf 2015;24:293–294.

  1. Himmelstein ,David U., MD, Steffie Woolhandler, MD, MPH,Letter- Physician Payment Incentives to Improve Care Quality, JAMA January 15, 2014 Volume 311, Number 3, 304.

  1. Iglehart , John K., Mission Versus Reality In Emergency Care, Health Affairs, 32, no.12 (2013):2066.

  1. James III, A. Everette,J D, Gellad Walid F., MD and Primack Brian A., MD, Implications of New Insurance Coverage for Access to Care, Cost-Sharing, and Reimbursement JAMA January 15, 2014 Volume 311, Number 3.

  1. Liberatore Matthew J., (2013) "Six Sigma in healthcare delivery", International Journal of Health Care Quality Assurance, Vol. 26 Issue: 7, pp.601 – 626.

  1. Meltze ,David O. and Chung,Jeanette W., The Population Value Of Quality Indicator Reporting: A Framework For Prioritizing Health Care Performance Measures, HEALTH AFFAIRS 33, NO. 1 (2014): 132–139.

  1. Ouyang, Helen; The art of Discharge; JAMA May 26, 2015 Volume 313, Number 20, 2027-2028

  1. Papanicolas ,Irene, Cylus ,Jonathan and Smith Peter C., An Analysis Of Survey Data From Eleven Countries Finds That 'Satisfaction' With Health System Performance Means Many Things Health Affairs, 32, no.4 (2013):734-742.

  1. Perlin, Jonathan B., Rapid Core Measure Improvement Through a “Business Case for Quality” Journal for Healthcare Quality, Mar/April 2012, Vol. 36, No. 2, pp. 50–61.

  1. Platonova, E and Shewchuk, R.; Patient Assessment of Primary Care physician Communication: Segmentation approach; International Journal of Health Care Quality Assurance, Vol 28, No. 4, 2015, 332-334

  1. Portela, M.C., et al, How to study improvement interventions: A brief overview of study types; BMJ Qual Saf 2015;24:325–336.

  1. Robert Shauna R. et al, Addressing Social Determinants to Improve HealthCare Quality and Reduce Cost, Journal for Healthcare Quality, Vol. 34, No. 2, 2012 pp. 12–20.

  1. Roland Martin, D.M., and Campbell Stephen, Ph.D. Successes and Failures of Pay for Performance in the United Kingdom, N Engl J Med (NEJM)370;20, May 15, 2014  Vol. 370 No. 20,1944-1949.

  1. Solecito, William A and Johnson Julie, K, 2013, McLaughlin and Kaluzny’s Continuous Quality Improvement in Healthcare, 4th Edition, Copyright 2013, Jones and Bartlett Publication, Massachusetts; ISBN 13: 978-0-7637-8154-5.

  1. Spath Patrice, Introduction to Quality Health Care Management, 2013, 2nd Edition, AUPHA, Health Administration Press, Chicago, Illinois.

  1. Spittal, J.M., et al; The PRONE score: An algorithm for predicting doctors’ risk of formal patient complaints using routinely collected administrative data; BMJ Qual Saf 2015;24:360–368.

  1. Westover Chad et al, Quality of Care in a Low-Income Consumer-Driven Health Plan: Assessment of Healthcare Effectiveness Data Information Set (HEDIS) Scores for Secondary Prevention Journal for Healthcare Quality, Volume 36, Issue 3, 28-34.

  1. Zuger, Abigail ; Hospital Ratings: A guide for the perplexed; JAMA May 19, 2015 Volume 313, Number 19, 1911-1912.

Section 2: Pre 2011- Important and Currently Relevant References:

  1. Adams, Karen, Greiner, Ann C., Corrigan, Janet M., Committee on Crossing the Quality Chasm: Next Steps toward a New Health Care System, 2004, 176 pages.

  1. Aspden, Philip, Corrigan, Janet M., Wolcott, Julie, Erickson, Shari M., Editors, Committee on Data Standards for Patient Safety; Patient Safety: Achieving a New Standard for Care, 2004, 550 pages

  1. Auerbach Andrew D., M.D., M.P.H., The Tension between Needing to Improve Care and Knowing How to Do It N Engl J Med, 357;6, August 9, 2007

  1. Benneyan J C, Statistical Process Control as a Tool for Research and Healthcare Improvement, Qual Saf Health Care 2003;12:458–464

  1. Berwick Donald, Payment by Capitation and the Quality of Care- Part 5 (1996) The New England Journal of Medicine, 335,16,1227-1231

  1. Blumenthal David, Quality of Care – What is it? – Part I, (1996) The New England Journal of Medicine, 335, 12, 891-894

  1. Blumenthal David, The Origins of Quality of Care Debate- Part 4 ( 1996) The New England Journal of Medicine, 335, 15, 1146-1149

  1. Brook Robert, McGlynn Elizabeth, Measuring Quality of Care – Part 2, (1996) The New England Journal of Medicine, 335, 13, 966-970

  1. Brown, RN, CPHQ, Janet A., The Healthcare Quality Handbook: A Professional Resource and Study Guide, 2004/2005 Edition (20th edition available after 7/31/05)

  1. Budetti, PP; 10 Years beyond the Health Security Act Failure: Subsequent Developments and Persistent Problems. 2004, JAMA; 292: 2000-2006

  1. Bush, GW, Ensuring Access to Health Care: The Bush Plan. JAMA, 2004; 292: 2010-2011

  1. Chassin Mark, Improving the Quality of Care- Part 3, (1996) The New England Journal of Medicine, 335, 14, 1060-1063

  1. Chassin Mark, Hannan Edward and DeBuono Barbara , Benefits and Hazards of Reporting Medical Outcomes Publicly ( 1996) The New England Journal of Medicine, 334,6, 394-398

  1. Couch James (Editor), Health Care Quality Management/Improvement Program for the 21st Century, 1991, American College of Physician Executives and American College of Medical Quality.

  1. Davies, H. O., Washington, A. Eugene, Health Care Report Cards: Implications for vulnerable patient groups and the organizations providing them care (2002), Journal of Health Politics, Policy and Law, Vol. 27, 379- 399

  1. Dlugacz, Yosef D., Alice Greenwood, Andrea Restifo; The Quality Handbook for Health Care Organizations: A Manager's Guide to Tools and Programs ISBN: 0787969214 Pub. Date: March 2004 Series: J-B AHA Press, #131

  1. Ellen Nolte and C Martin McKee, Measuring the health of nations: Updating an earlier analysis, Health Affairs, Volume 27, 58-71, 2008.

  1. Golub, Robert M, Beyond Mental Mediocrity, JAMA, 2006, 296, 1139-1140

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