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  1. Clinical process improvement as a means of facilitating health care system integration.

    Article - En anglais


    In recent years many health care providers, physicians, hospitals, and managed care organizations have undergone significant reorganization in both delivery and financing systems.

    This has created new organizations called integrated or organized delivery systems.

    Sentara Health System (Norfolk, Va), one of these new integrated entities, developed a unified strategy for clinical process improvement for the entire organization.

    This systemwide approach had unanticipated problems and benefits.


    The Sentara Health System created a team responsible for coordinating clinical process improvement activities across its hospitals and ambulatory physician sites.

    A steering committee directed this team to improve the organization and delivery of care for specific high-cost, high-volume, or problem-prone disease for physicians to manage.

    A standardized approach aimed at coordinating care across sites was the cornerstone of these activities.


    Significant improvements in patient outcomes and a concomitant decrease in costs of care were accomplished for multiple diseases and procedures.

    These projects uncovered unanticipated barriers to implementing improvement projects in a complex health care system which make implementing these activities far more difficult than for an individual hospital with its medical staff. (...)

    Mots-clés Pascal : Coopération, Gouvernement, Coopération internationale, Santé publique, Hôpital, Ambulatoire, Soin, Relation professionnelle, Travail, Politique internationale, Politique sanitaire, Condition travail

    Mots-clés Pascal anglais : Cooperation, Government, International cooperation, Public health, Hospital, Ambulatory, Care, Professional relation, Labour, International policy, Health policy, Working condition

    Logo du centre Notice produite par :
    Observatoire Régional de la Santé Auvergne-Rhône-Alpes

    Code Inist : 002B30A11. Création : 11/09/1998.