Continuous Quality Improvement and the Care of Persons with Multiple Sclerosis: Two Case Studies

Abstract

The principles of Continuous Quality Improvement (CQI) continue to gain acceptance as a means of improving health care delivery. They are especially appropriate in the out patient management of a chronic progressive disease such as multiple sclerosis (MS). This paper reviews why CQI facilitates care with this type of disease; discusses how one clinical facility, The Cleveland Clinic Foundation Mellen Center for Multiple Sclero sis Treatment and Research, has implemented these principles in defining and revising our general clinical operation; and describes how these same techniques are useful in developing (a) administrative strategies and (b) a treatment plan for one individual. Key Words: Multiple sclerosis—Continuous quality improvement—Comprehensive care.

References

Scheinberg LC , Giesser BS , Slater RJ Management of the chronic MS patient. Neurology and Neurosurgery Update Series 1983;4(21):18.

Peyser JM , Poser CM Neuropsychological correlates of multiple sclerosis. In: Filskor SM , Bolls TJ (eds.). Handbook of clinical neuropsychology. New York: John Wiley, 1986:364-94.

Rao Sm. Neuropsychology of multiple sclerosis: a critical review . Journal of Clinical and Experimental Neuropsychology 1986;8:503-42.

Neuhauser D. The quality of medical care and the 14 points of Edwards Deming. Health Matrix 1988;6(2):7-10. Reprinted in Kovner A. , Neuhauser D. Health services management readings and commentary, 4th ed. Ann Arbor: Ann Arbor Health Administration Press, 1988.

Chaufournier RL , St. Andre C. Total quality management in an academic health center. Quality Progress 1993:63-66.

Headrick L. , Neuhauser D. , Melnikow J. , Vanek E. , Miller D. , Christie R. , Katcher W. , and Primary Care Clerkship Students. Improving the quality and cost of care: workbook of the CWRU Cleveland asthma project, 4th ed. Cleveland: Case Western Reserve University, 1992.

Ott E. Analysis of means testing. Journal of Quality Technology 1983;17:10-18.

Ritvo PG , Miller DM , Fischer JF , LaRocca NG , Andrews. A proposal submitted in response to special research initiative for the development of a quality-of-life outcomes assessment battery in multiple sclerosis. Consortium of Multiple Sclerosis Centers, 1993.

Ott E. Analysis of means testing. Journal of Quality Technology 1983;17:10-18.

10.

Miller D. Caregiving in chronic illness: the experience of married persons whose spouses have MS. Mandel School of Applied Social Sciences, Case Western Reserve University. Unpublished doctoral dissertation, 1990.