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Current COLMR Projects
An Evaluation of Pursuing Perfection: Raising the Bar for Health Care Performance
The Robert Wood Johnson Foundation (RWJF) Pursuing Perfection program is funding grants to seven organizations that have implemented plans to dramatically improve patient outcomes by pursuing perfection in all major care processes. HSR&D's Management Decision and Research Center, through its academic affiliates at Boston University (Schools of Public Health and Management), has been commissioned by RWJF to evaluate transformation in the seven organizations. Joe Restuccia, Dr.PH, and Sally Holmes, MBA, both co-investigators on the Pursuing Perfection evaluation team, have been invited to participate on an advisory group for the New York State Department of Public Health's evaluation of the international HIV/QUAL program.
The Pursuing Perfection program, which grew out of two Institute of Medicine reports: To Err is Human and Crossing the Quality Chasm, defines quality as always delivering the right care, never providing care that has no potential to help a patient, and never harming a patient in the course of providing care. The Pursuing Perfection program evaluation will focus on:
- Determining the extent to which an organization succeeds in achieving the improvement goals articulated in its plan, and
- Identifying factors that contribute to each organization's successes and/or failures.
Study Design
The organizational change sought by Pursuing Perfection in each site may be thought of in two stages: (1) initial interventions in first two, and then five additional projects at each of the seven sites, and (2) diffusion of change throughout the rest of the organization. Sites may be successful in individual projects, but may still be unable to achieve a total organizational transformation that supports and stimulates the Pursuing Perfection values. Specifically, we will measure:
- Whether a critical level of forces for change has been achieved to "tip" the organization into an entirely new way of functioning;
- The extent to which individuals are aware of philosophies, values, and practices embodied in the Pursuing Perfection program, as well as the extent to which they adopt and diffuse them to others;
- The extent to which the organization achieves the IOM's six key aims for health care improvement; and
- The context of the organization, including how organizational structure, rewards, and information systems support or discourage desired changes.
Data will be drawn from site visits every four months, a staff survey conducted twice over two years, review of archival material, and an audit of data used by the organizations to report on progress in their efforts. In addition to the seven participating sites, we will also collect data from sites that have been recognized for providing high quality health care, as well as semi-finalists in the Pursuing Perfection selection process.
The evaluation is funded by the Robert Wood Johnson Foundation.
For more information about the evaluation, please contact Martin Charns, DBA (martin.charns@va.gov) or Irene Cramer, Ph.D (irene.cramer@va.gov).
Links of Interest
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