The Elusive Quest: Accountability in Hospitals (Social Problems & Social Issues) Book

This book examines the elaborate and costly enterprise that has been developed to hold hospitals accountable for improved quality. Not only has a huge oversight apparatus been established for this purpose but the arena devised for it—comprised of consultants, measurement experts, researchers, software developers, producers of information systems, oversight agencies, and hospital personnel charged with implementing quality measures—continues to expand. After placing the accountability arena in its historical, economic, and sociological context, Wiener challenges the appropriateness of management techniques inherited from industry, the feasibility of standardizing care through practice guidelines, and the concept that hospital performance should be quantitatively measured. Analyzing how hospitals differ from the corporate industries with which they are usually compared, the author pinpoints the poor fit of an industrial model in a setting where professionals from diverse disciplines provide highly sophisticated care to patients whose individual biographies defy categorization and whose course of disease is idiosyncratic. Wiener demonstrates how the existing quality measures fail to deal with the most serious problem facing hospitals: how to reduce medical accident and error in what have become exceedingly high-risk, complex organizations. CONTENTS Preface · Glossary of Acronyms · Introduction · 1. Antecedents to the Accountability Movement: The Era of Growth · 2. The Era of Accountability: Rationalization, Regulation, and Restructuring · 3. Formalizing the Accountability Endeavor: Forging a Path from Quality Assurance to Quality Improvement · 4. Implementing the Accountability Endeavor: Overcoming Assumptions and Surmounting Obstacles · 5. Demonstrating the Accountability Endeavor: The Art of Show and Tell · 6. Reassessing Accountability · References · IndexRead More