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Phone: 804.754.7626
Fax: 804.740.9401
Email: contact@soix.com
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Academic Background
Quality Indicators
The development of the Outcomes Monitoring System for Ambulatory Surgery has a firm academic background. It started in June 1996 in the Williamson Institute for Health Studies at Virginia Commonwealth University, Richmond, Virginia, USA. The pilot data files opened on the Internet in December 1996, and the initial members web site opened in May 1997.
The system indicators are based on a study undertaken by the Illinois Hospital & HealthSystems Association which was funded by the RWJ Foundation. Though originally designed for the acute care setting, the indicators have been adapted and enhanced to serve the ambulatory surgery setting.
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This development was partially funded by an unrestricted grant from Pfizer, Inc.
The Outcomes Monitoring System for Ambulatory Surgery was supported methodologically by the American Association of Ambulatory Surgery Centers (AAASC) through a pilot study undertaken at a number of AAASC member centers. The prototype testing results showed the importance and usefulness of the system for comparing surgical outcomes across surgery centers and the possibility to serve as a tool for accreditation of ambulatory surgery centers.
Applied systems analysis
- a superficial, run-of-the-mill reporting system will produce stacks of
numerical tables and charts with basic, primitive data which is hardly an appreciable
support to making managerial decisions
- applied systems analysis creates synthetic indicators derived
from these basic, primitive data and presents to decision makers the analytic results,
not the bare-bones data.
- in OMS, a decision support system, these analytic indicators are
presented in combined tables and charts for easy comparison benchmarking.
There may be found thousands of indicators reflecting the quality and outcomes of medical procedures. The Systems Theory tells that at the different stages and for diferent purposes the adequate inicators should be carefully selected. At the initial stage of the quality and outcomes monitoring, when very little is known about the functioning of the system, a minimal set of generalized indicators needs to be defined and applied.
If at this stage the attention is distracted with numerous details, this may lead to wasting resources to assess quite insignificant criteria. We know of some outcomes systems that attempt to monitor dozens of indicators and create hundreds of pages of extremely detailed reports monthly so that the managers will drown in the impressively looking charts and tables - without seeing the essence of the situation.
The idea of OMS
The idea of OMS was to define a small number of the most significant indicators and then create a minimal set of understandable reports designed hierarchically - the top level being THE EXECUTIVE BENCHMARK REPORT that in a single page shows the position of a specific center among the peers and the current trends in the indicators -- improvement or worsening. The lower level reports give more details in the minimal selected indicators set.
For inclusion in the system were approved 10 quality indicators to monitor patient outcomes. These indicators were selected because there was an agreement that they focused on important quality issues. In addition, the indicators provide adequate information to support continuous improvement, serve as pattern identification screens, require minimal data collection resources, and provide easily understood information for all levels of personnel involved in quality initiatives and the provision of patient care.
The selected indicators describe the surgery complications, pain control, patient turnover, and patient satisfaction. Versions of OMS starting with 3.0 include also the cost indicators.
While these indicators are not direct measures of quality, they can identify performance issues that may require more intense review within an individual organization or peer groups of organizations. The selected indicators systematically monitor the most important aspects of patient care continuously at the patient level. This level of detail helps surgery centers more specifically identify areas or procedures that may need improvement.
The indicator analysis presented in the feedback reports will enable surgery centers to compare themselves to a benchmark based on aggregate data to identify thresholds that signal the need for organizational improvement.
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