Quest for qual­ity

Im­prove­ments must come from pri­vate-pub­lic col­lab­o­ra­tion

Modern Healthcare - - Opinions Commentary - Chip Kahn

Job one for health re­form is to ex­pand cov­er­age to mil­lions of Amer­i­cans who lack it. The prom­ise of health re­form, though, would be un­ful­filled without a thor­ough and on­go­ing com­mit­ment to im­prov­ing health­care qual­ity.

For hos­pi­tals, im­prov­ing health­care qual­ity re­mains a na­tional im­per­a­tive. In the roughly 10 years since the In­sti­tute of Medicine pub­lished its sem­i­nal re­port, To Err is Hu­man: Build­ing a Safer Health Sys­tem, hos­pi­tals and other clin­i­cians, con­sumers, busi­ness, la­bor, in­sur­ers and pay­ers have made sig­nif­i­cant strides in im­prov­ing pa­tient care by de­vel­op­ing stan­dard­ized qual­ity mea­sures, gath­er­ing and an­a­lyz­ing health­care qual­ity and safety data, post­ing the data to na­tional Web sites and shar­ing best prac­tices in­for­ma­tion.

And yet, we’ve only just be­gun and still have a long way to go.

Qual­ity im­prove­ment can best be built on the mo­men­tum gen­er­ated by pub­lic-pri­vate col­lab­o­ra­tive ac­tiv­i­ties al­ready un­der way to pro­mote im­prove­ment in health­care qual­ity and af­ford­abil­ity. As such, the Stand for Qual­ity coali­tion was formed just over a year ago.

The group that came to­gether rep­re­sents the peo­ple and or­ga­ni­za­tions that ad­vo­cate for the rights of pa­tients and con­sumers, de­liver care, op­er­ate health plans, man­u­fac­ture drugs and other de­vices, and pur­chase and reg­u­late care on the pub­lic’s be­half. Their ef­forts are fo­cused on mak­ing U.S. health­care safer, more ef­fec­tive and more ef­fi­cient.

Stand for Qual­ity be­lieves that though we must make big­ger and bet­ter strides in nar­row­ing the vari­a­tion of out­comes in the flawed de­liv­ery sys­tem, if we build on what we know works al­ready, we will trans­form care de­liv­ery and im­prove over­all qual­ity in health­care. Key el­e­ments of the plan in­volve set­ting pri­or­i­ties and a strat­egy, and mea­sur­ing, re­port­ing and im­prov­ing dis­sem­i­na­tion of lessons learned.

This type of change re­quires those who are part of the health­care sys­tem it­self be­ing will­ing to put dif­fer­ences aside and think and act anew. Such is the model of the Stand for Qual­ity col­lab­o­ra­tion.

How­ever, the Stand for Qual­ity agenda re­quires leg­isla­tive au­thor­ity. The House and Se­nate health re­form mea­sures in­clude many of the el­e­ments nec­es­sary to trans­form qual­ity pa­tient care and care de­liv­ery in the U.S.

Stand for Qual­ity be­lieves the fol­low­ing el­e­ments are es­sen­tial for a ro­bust qual­ity in­fra­struc­ture:

De­velop na­tional pri­or­i­ties and goals for qual­ity im­prove­ment. The HHS sec­re­tary should be given the au­thor­ity to set na­tional pri­or­i­ties through a mul­ti­stake­holder process to guide mea­sure de­vel­op­ment, re­port­ing and im­prove­ment ac­tiv­i­ties, and as­sess progress in achiev­ing them. A clear road map for change will fo­cus the ex­pen­di­ture of re­sources, give clin­i­cians clear di­rec­tion and drive change faster.

De­velop and pro­mote the use of con­sen­sus qual­ity mea­sures aimed at ad­dress­ing the na­tional pri­or­i­ties. Qual­ity con­sen­sus mea­sures that bench­mark care are crit­i­cal to ef­forts to con­tin­u­ously im­prove and gauge progress over time. Mea­sures also pro­vide clin­i­cians with nec­es­sary feed­back on their per­for­mance, and it pro­vides pa­tients and their fam­i­lies with in­for­ma­tion to make in­formed choices and al­low them to be bet­ter part­ners in their health­care.

Pro­mote qual­ity im­prove­ment through de­vel­op­ment and test­ing of in­no­va­tive care mod­els. Qual­ity im­prove­ment re­quires re­sources for fos­ter­ing in­no­va­tive method­olo­gies and strate­gies to im­prove care de­liv­ery. Th­ese new prac­ti­tioner tools must be grounded in re­li­able, sound per­for­mance data.

En­gage mul­ti­stake­holder pub­lic-pri­vate part­ner­ships in a con­sul­ta­tion process on the use and im­ple­men­ta­tion of en­dorsed mea­sures in pub­lic re­port­ing and pay­ment pro­grams, such as the Medi­care pay-for-re­port­ing pro­grams. This en­cour­ages buy-in and a com­mit­ment to im­prove care de­liv­ery us­ing proven prac­tices. It also helps to pro­vide pa­tients with rel­e­vant in­for­ma­tion about the care they re­ceive.

De­velop new tech­niques for data ag­gre­ga­tion and the use of elec­tronic data col­lec­tion. Mea­sure­ment and re­port­ing only is as good as the data go­ing into the sys­tem, and our cur­rent sys­tem needs to be im­proved.

Re­port on the progress be­ing made to­ward the na­tional pri­or­i­ties and the suc­cesses of the new tech­niques and im­prove­ment in care. Pe­ri­odic re­port­ing on progress to­ward na­tional pri­or­i­ties pro­vides trans­parency and en­cour­age­ment to con­tinue the trans­for­ma­tion of the sys­tem. It also af­fords an op­por­tu­nity to re­tool should that be nec­es­sary.

The po­ten­tial is im­mense for build­ing on cur­rent ac­tiv­i­ties to cre­ate a sus­tain­able in­fra­struc­ture.

This in­fra­struc­ture will im­prove care de­liv­ered to pa­tients, lower costs and achieve our shared goal of mak­ing high-qual­ity af­ford­able health­care avail­able to all. A fi­nal health re­form mea­sure should main­tain th­ese pro­vi­sions.

How­ever, if health re­form does not pass, th­ese el­e­ments must find a home in fu­ture leg­is­la­tion.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.