Presents the results of a two-year study that analyzes how patient safety practices are being adopted by U.S. health care providers, examines hospital experiences with a patient safety culture survey, and assesses patient safety outcomes trends. In case studies of four U.S. communities, researchers collected information on the dynamics of local patient safety activities and on adoption of safe practices by hospitals.
In partnership with the Army Medical Department, RAND worked to implement clinical practice guidelines. This report evaluates the asthma guideline demonstration. It documents the actions, assesses effects, and measures the quality and limitations of data for monitoring outcomes. The authors found that the implementation scored successes but resource limitations and organizational barriers curbed progress. They conclude that flexibility, monitoring, and training are the keys to implementing the guidelines. They also found that patient education needed improvement.
Examines the effects of the California Work Opportunity and Responsibility to Kids (CalWORKs) program on work activity participation rates of welfare recipients, welfare caseloads, and outcomes for welfare leavers. While the CalWORKs reforms appear to have been responsible for some of the uniform improvement in outcomes shown by the analysis, the robust economy and other policy changes were probably also important.
Addresses one step in the process of moving from teamwork training to teamwork practices that improve outcomes of care: identifying outcomes that are most likely to be affected as teamwork practices improve in an implementing organization. Discusses a literature search, methods for selecting and testing candidate measures, measures highly rated by clinical experts, and results of measure testing on administrative data of the DoD health system.
The Tobacco Settlement Proceeds Act, a referendum passed by Arkansans in the November 2000 election, invests Arkansas' share of the tobacco Master Settlement Agreement funds in seven health-related programs. RAND was contracted to evaluate the progress of the seven programs in fulfilling their missions, as well as the effects of the programs on smoking and other health-related outcomes. This report charts the progress of each program, including assessing progress in achieving long-range goals established by the programs in 2005, tracking the programs' process measures, and assessing performance on a set of program management integrity criteria. The report also updates trends in outcome measures developed to monitor effects of the funded programs on smoking and other health-related outcomes. Finally, it provides program-specific and across-program recommendations for future activities and funding.
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