Return on Investment for Healthcare Quality Improvement

Chapter 1. Introduction
1.1 The Current Healthcare Environment
1.1.1 Funding Requirements for Those Looking to Improve Care Quality
1.2 Concepts of Value in Quality Improvement
1.2.1 A Discussion of "Value" in Health Care
1.2.2 The Journey of Understanding Value in Relation to that of Quality
1.3 Quality Improvement as an Exercise in Influence
1.4 Return on Investment
1.4.1 How ROI is Used in Other Industries
1.4.2 How We Will Define ROI
1.4.3 Unique Challenges for Examining ROI in the Healthcare Setting
1.4.4 Differences in Prospective Versus Retrospective Analyses of ROI
1.5 Who this Book Is For
1.6 Chapter Summary
1.7 Key Concepts
References

Chapter 2: Planning an ROI Analysis
2.1 The Motivation to Assess Value in Health Care
2.2 The Critical Aspects of Quality Improvement
2.2.1 Defining Quality
2.2.2 Measuring Quality
2.2.3 Assessing and Evaluating Quality
2.3 Measuring Value
2.3.1 Considering What Can Be Improved, Measured, and Monetized
2.3.2 Planning the Value Assessment in Tandem with the Quality Assessment
2.4 Definitions and Terms
2.4.1 ROI2.4.2 Benefit-to-Cost Ratio (Benefits per Dollar Spent)
2.4.3 Savings per Patient
2.4.4 Payback Period
2.4.5 Other Metrics
2.5 Basic ROI Design
2.5.1 Scope and Perspective
2.5.2 Costs and Benefits
2.5.3 Base Case and Sensitivity Analyses
2.5.4 Interpretation
2.6 Hypothetical Case Studies
2.6.1 Example 1: Nursing Home Falls
2.6.2 Example 2: Improved Hospital Discharge Process
2.6.3 Example 3: Introducing a Collaborative Care Model
2.6.4 Example 4: Investing in Facility Improvements2.7 Chapter Summary
2.8 Key Concepts
References

Chapter 3: Initial Steps
3.1 Define Scope and Perspective
3.1.1 Perspective
3.1.2 Scope
3.1.3 Practical Examples of Defining the Scope and Perspective
3.1.4 Major Assumptions and Their Implications
3.2 Determine What to Measure
3.2.1 Process Versus Outcome Measures
3.2.2 Individual Versus Composite Measures
3.2.3 One Versus Many Measures
3.2.4 The Impact of Project Characteristics on Measures
3.3 How to Select Quality Improvement Opportunities for Value
3.3.1 Questions to Ask
3.4 How to Estimate the Expected Effectiveness and Associated Value
3.4.1 Pulling from Your Own Experience
3.4.2 Pulling from Published Literature
3.5 Secure Buy-In and Recruit Partners3.6 Chapter Summary
3.7 Key Concepts

Chapter 4: Costs and Benefits
4.1 The Impact of Scope and Perspective on Costs and Benefits
4.2 Costs
4.2.1 Identifying Cost Sources
4.2.2 Estimating and Monetizing Costs
4.2.3 Aggregating Costs
4.3 Benefits
4.3.1 Measurable, Monetizable, and Directly Attributable Benefits
4.3.2 Estimating MMA Benefits
4.3.3 Estimating Non-MMA Benefits
4.3.4 Calculating Benefits (Formulas)
4.4 Discounting
4.5 Chapter Summary
4.6 Key Concepts
References

Chapter 5: Performing Base Case and Sensitivity Analyses
5.1 Prospective versus Retrospective ROI Analyses
5.2 Developing the Base Case Scenario5.2.1 General Considerations for the Base Case
5.2.2 Identifying Usable Estimates
5.2.3 Applying the Perspective and Scope to the Base Case
5.2.4 A Base Case Example
5.3 Sensitivity Analysis
5.3.1 General Consideratio