Learning Curves in Health Care

This article explores the uses of learning curve theory in medicine. Though effective application of learning curve theory in health care can result in higher quality and lower cost, it is seldom methodically applied in clinical practice. Fundamental changes are necessary in the corporate culture of medicine in order to capitalize maximally on the benefits of learning.

[1]  N. Powe,et al.  The association between hospital volume and survival after acute myocardial infarction in elderly patients. , 1999, The New England journal of medicine.

[2]  H. Luft,et al.  The volume-outcome relationship: practice-makes-perfect or selective-referral patterns? , 1987, Health services research.

[3]  E. Hannan,et al.  A longitudinal analysis of the relationship between in-hospital mortality in New York State and the volume of abdominal aortic aneurysm surgeries performed. , 1992, Health services research.

[4]  C. Bailey Forgetting and the learning curve: a laboratory study , 1989 .

[5]  L. Argote,et al.  Learning Curves in Manufacturing , 1990, Science.

[6]  J. Mayer,et al.  Factors influencing early and late outcome of the arterial switch operation for transposition of the great arteries. , 1995, The Journal of thoracic and cardiovascular surgery.

[7]  Nicholas Baloff,et al.  Extension of the Learning Curve — Some Empirical Results , 1971 .

[8]  A R Kovner,et al.  Evidence‐Based Management , 2000, Frontiers of health services management.

[9]  J. Bronstein,et al.  The effects of patient volume and level of care at the hospital of birth on neonatal mortality. , 1996, JAMA.

[10]  E. Edwards,et al.  The Effect of Transplant Center Volume on Cardiac Transplant Outcome: a Report of the United Network for Organ Sharing Scientific Registry , 1995 .

[11]  J. Hood,et al.  Corporate Culture: The Missing Piece of the Healthcare Puzzle , 2003, Hospital topics.

[12]  G. Stone,et al.  Operator and institutional volume do not affect the procedural outcome of primary angioplasty therapy , 1996 .

[13]  S. Pappelbaum,et al.  Containing costs in the treatment of congenital heart disease. , 1984, The Western journal of medicine.

[14]  D B Smith,et al.  The impact of learning on cost: the case of heart transplantation. , 1989, Hospital & health services administration.

[15]  S. Ellis,et al.  Relation of operator volume and experience to procedural outcome of percutaneous coronary revascularization at hospitals with high interventional volumes. , 1997, Circulation.

[16]  T. Bilfinger,et al.  Coronary artery bypass grafting. The relationship of surgical volume, hospital location, and outcome. , 1991, New York state journal of medicine.

[17]  T. Caeiro,et al.  [Error in medicine]. , 2004, Medicina.

[18]  B. Hillner,et al.  Hospital volume and patient outcomes in major cancer surgery: a catalyst for quality assessment and concentration of cancer services. , 1998, JAMA.

[19]  S. Kerr On the folly of rewarding A, while hoping for B. , 1975, Academy of Management journal. Academy of Management.

[20]  W. Sacco,et al.  Institution and per-surgeon volume versus survival outcome in Pennsylvania's trauma centers. , 1995, American journal of surgery.

[21]  D. Pryor,et al.  The relation between the volume of coronary angioplasty procedures at hospitals treating Medicare beneficiaries and short-term mortality. , 1994, The New England journal of medicine.

[22]  William H. Mobley,et al.  Employee turnover : causes, consequences, and control , 1983 .

[23]  A. Moskowitz,et al.  Volume-outcome relationships in cardiovascular operations: New York State, 1990-1995. , 1999, The Journal of thoracic and cardiovascular surgery.

[24]  T. P. Wright,et al.  Factors affecting the cost of airplanes , 1936 .

[25]  C. Begg,et al.  Impact of hospital volume on operative mortality for major cancer surgery. , 1998, JAMA.

[26]  A. Kastrati,et al.  Operator volume and outcome of patients undergoing coronary stent placement. , 1998, Journal of the American College of Cardiology.

[27]  Harold S. Luft,et al.  Association of volume with outcome of coronary artery bypass graft surgery —scheduled vs nonscheduled operations , 1987, JAMA.

[28]  Gary P. Pisano,et al.  Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery , 2001, Manag. Sci..

[29]  Robert I. Sutton,et al.  The knowing-doing gap , 2000 .

[30]  E. DeLong,et al.  Relationship between physician and hospital coronary angioplasty volume and outcome in elderly patients. , 1997, Circulation.

[31]  E S Fisher,et al.  Effect of hospital volume on in-hospital mortality with pancreaticoduodenectomy. , 1999, Surgery.

[32]  E L Hannan,et al.  Coronary angioplasty volume-outcome relationships for hospitals and cardiologists. , 1997, JAMA.

[33]  Steven C. Wheelwright,et al.  Massachusetts General Hospital: CABG Surgery (A) , 1995 .

[34]  Louis E. Yelle THE LEARNING CURVE: HISTORICAL REVIEW AND COMPREHENSIVE SURVEY , 1979 .

[35]  Raymond B. Jordan,et al.  How to use the learning curve , 1965 .

[36]  R. Glasgow,et al.  Hospital volume influences outcome in patients undergoing pancreatic resection for cancer. , 1996, The Western journal of medicine.

[37]  Shlomo Globerson,et al.  The Influence of Job Related Variables on the Predictability Power of Three Learning Curve Models , 1980 .

[38]  K Walshe,et al.  Evidence-based management: from theory to practice in health care. , 2001, The Milbank quarterly.

[39]  T A Sheldon,et al.  Volume and outcome in coronary artery bypass graft surgery: true association or artefact? , 1995, BMJ.

[40]  ``Physicians Must Abandon the Illusion of Autonomy . . .'' , 1998, Pediatric Cardiology.

[41]  J D Waldman,et al.  Pediatric cardiac catheterization with same-day discharge. , 1982, The American journal of cardiology.

[42]  D. McDowell Foreword , 1999 .

[43]  L. Klein,et al.  Does low individual operator coronary interventional procedural volume correlate with worse institutional procedural outcome? , 1997, Journal of the American College of Cardiology.

[44]  E. Edwards,et al.  The Effect of Transplant Center Volume on Cardiac Transplant Outcome: A Report of the United Network for Organ Sharing Scientific Registry , 1994 .

[45]  Steven A. Yourstone,et al.  Managed care and medical practice guidelines: The thorny problem of attaining physician compliance , 2001 .

[46]  E. Hannan,et al.  Pediatric cardiac surgery: the effect of hospital and surgeon volume on in-hospital mortality. , 1998, Pediatrics.

[47]  S. Spear,et al.  Decoding the DNA of the Toyota Production System , 1999 .

[48]  T. To,et al.  Relation between hospital surgical volume and outcome for pancreatic resection for neoplasm in a publicly funded health care system. , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[49]  R. E. Clark Outcome as a function of annual coronary artery bypass graft volume. The Ad Hoc Committee on Cardiac Surgery Credentialing of The Society of Thoracic Surgeons. , 1996, The Annals of thoracic surgery.

[50]  Thomas J. Ryan,et al.  Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Percutaneous Transluminal Coronary Angioplasty). , 1993, Journal of the American College of Cardiology.

[51]  M. Chassin Is health care ready for Six Sigma quality? , 1998, The Milbank quarterly.

[52]  H S Luft,et al.  Association of volume with outcome of coronary artery bypass graft surgery —scheduled vs nonscheduled operations , 1987, JAMA.