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OCR for page 19
Interpreting the Volume–Outcome Relationship in the Context of Health Care Quality: Workshop Summary
APPENDIX A
Workshop Agenda
INSTITUTE OF MEDICINE
Division of Health Care Services, Committee on Quality in Health Care in America
National Cancer Policy Board
May 11, 2000
OBJECTIVES
Review evidence of the relationship between volume of services and health-related outcomes.
Discuss methodological issues related to the interpretation of the association between volume and outcome.
Assess the applicability of volume as an indicator of quality of care.
Identify research needed to better understand the volume-outcome relationship and its application to quality improvement.
AGENDA
9:00 a.m.–9:30 a.m.
Welcome and introduction: Diana Petitti
Opening remarks: John Eisenberg
Session 1
9:30 a.m.–12:15 p.m.
Overview of the Volume-Outcome Relationship
Opening remarks: Mark Chassin
9:30 a.m.–10:30 a.m.
Presentation of background paper: “Synthesis of Evidence from the Literature,” Ethan Halm
10:30 a.m.–10:45 a.m.
Coffee break
10:45 a.m.–12:15 p.m.
Roundtable discussion Moderators: Mark Chassin and Jane Sisk
Is the association consistent across conditions/procedures/services?
What factors might explain the association?
OCR for page 20
Interpreting the Volume–Outcome Relationship in the Context of Health Care Quality: Workshop Summary
What measurement issues need to be addressed (e.g., defining volume, thresholds/cutpoints, units of analysis)?
Does the evidence support applying volume as a quality-of-care measure?
What additional research is needed?
Reactors/discussants: Edward Hannan, Norman Hertzer, Colin Begg, Bruce Hillner, Arnold Milstein
12:15 p.m.–l:15 p.m.
Lunch
Session 2
1:15 p.m.–3:30 p.m.
Policy implications Opening remarks: Diana Pettiti
1:15 p.m.–l :45 p.m.
Presentation of background paper—“When and How Could Volume Be Used as an Indicator of Quality Care? ” Adams Dudley
1:45 p.m.–3:30 p.m.
Roundtable discussion Moderators: Don Berwick and Robert Galvin
What level of evidence is needed to support policies?
What are the strengths and weaknesses of alternative implementation strategies?
What are the potential barriers to applying volume as an indicator of quality (e.g., access in rural areas, patient preferences for care close to home)
What policy-relevant health services research is needed?
Reactors/discussants:
Consumer perspectives: Art Levin and Ellen Stovall
Purchaser perspectives: Bruce Bradley, Steven Clauser, and Irene Fraser
Managed care: George Isham and Sam Ho
Provider groups: Don Nielsen
Session 3
3:30 p.m.–4:00 p.m.
Where do we go from here?
Moderator: Joseph Simone
Wrap-up: Discussion of findings and research needs
4:00 p.m.
Workshop Adjourns
OCR for page 21
Interpreting the Volume–Outcome Relationship in the Context of Health Care Quality: Workshop Summary
PARTICIPANTS
Colin Begg
Memorial Sloan-Kettering Cancer Center
New York, NY
Donald M. Berwick
Institute for Healthcare Improvement
Boston, MA
Richard Bae
University of California
San Francisco, CA
Bruce Bradley
General Motors
Detroit, MI
Mark R. Chassin
The Mount Sinai School of Medicine
New York, NY
Steven Clauser
Health Care Financing Administration
Baltimore, MD
Jan De la Mare
Agency for Healthcare Research and Quality
Rockville, MD
Suzanne DelBanco
The Leapfrog Group
Washington, DC
R. Adams Dudley
UC San Francisco
San Francisco, CA
John Eisenberg
Agency for Healthcare Research and Quality
Rockville, MD
Irene Fraser
Agency for Healthcare Research and Quality
Rockville, MD
Robert Galvin
General Electric Company
Fairfield, CT
Ethan Halm
The Mount Sinai School of Medicine
New York, NY
Edward Hannan
State University of New York at Albany
Rensselaer NY
Norman Hertzer
Cleveland Clinic
Cleveland, OH
Bruce Hillner
Virginia Commonwealth University
Richmond, VA
Sam Ho
Pacificare Health Systems
Santa Anna, CA
George J. Isham
HealthPartners
Bloomington, MN
Clara Lee
The Mount Sinai School of Medicine
New York, NY
Arthur Levin
Center for Medical Consumers
New York, NY
Arnold Milstein
William M. Mercer, Inc
San Francisco, CA
Peggy McNamara
Agency for Healthcare Research and Quality
Rockville, MD
OCR for page 22
Interpreting the Volume–Outcome Relationship in the Context of Health Care Quality: Workshop Summary
Don Nielsen
American Hospital Association
Chicago, IL
Diana Petitti
Kaiser Permanente of Southern California
Pasadena, CA
Joseph Simone
Huntsman Cancer Foundation and Institute
Salt Lake City, UT
Jane Sisk
Mount Sinai School of Medicine
New York, NY
Ellen Stovall
National Coalition for Cancer Survivorship
Silver Spring, MD
IOM and NCPB Staff
Janet M. Corrigan, Program Director, IOM
Maria Hewitt, Senior Program Officer, NCPB
Ellen Johnson, Administrative Assistant, NCPB
Kelly C. Pike, Senior Project Assistant, IOM
Representative terms from entire chapter:
diana petitti