William Claiborne Dunagan, M.D.
Assistant Professor of Medicine
Vice President, System Quality for BJC Health System

Office: (314) 286-2165
FAX: (314) 286-2050
E-mail:cdunagan@imgate.wustl.edu

Office: 4444 Forest Park Parkway, Room 532

Quality improvement has become a central element in health care reform, and most health care systems now devote significant resources to quality improvement programs.  However, many of the techniques and methods used for quality improvement have not undergone rigorous evaluation.  The Center for Quality Management is a collaborative program between Washington University and BJC Health System focused on improving the quality and efficiency of health care delivered within BJC.  The Center is responsible for organizing the performance assessment program for the system and for ensuring the effective use of performance data for improving health care processes.  Relevant performance measures include clinical outcomes, financial performance, and patient and physician satisfaction, among others.  Databases containing such information provide an excellent opportunity for using epidemiological principles to examine critical determinants of health care quality.  Extensive clinical, financial, and patient satisfaction databases already exist for hospitals throughout the system, and collaborative projects will allow creation of new clinical outcomes databases.  In addition, the center has access to extensive databases containing microbiology and medication administration records. The center also actively is engaged in assessing strategies for improving patient care, including industrial process improvement and redesign techniques, as well as clinical practice guidelines and clinical pathways.  The partnership with BJC will allow researchers within the center to use a large integrated delivery system as a laboratory for testing patient care strategies.  Current projects include examinations of the utility of clinical pathways, physician performance profiling, and multi-institutional collaborative improvement models.