Saturday, February 07, 2004
Quality of Care: Whose Job?
During the popularity of Total Quality Management in the 1980’s, the Ford Motor Company adopted the slogan Quality is Job One.
Quality is moving in that direction in health care, but the question seems to be not so much where it stands on the priority list, but whose job it is.
Jeff Tieman recently had two articles on this topic in Modern Healthcare. The first, in the January 5, 2004 issue, reported on the recently issued AHRQ (the HHS Agency for Healthcare Research and Quality) annual report on healthcare quality. After reviewing the contents of the report, Tieman concluded that “….who ultimately accepts responsibility for better quality – patients, hospitals, health plans or the government – is still undetermined.”
The second appeared in the January 20, 2004 issue. That one discussed the activities of the various national organizations that are attempting to promote improved quality in health care. In this case, Tieman concluded that “….there is no broad agreement on how the industry and its stakeholders should move forward and what the exact goals should be.”
There were nuggets in both articles, however, that suggested how all of this ultimately might get clarified. The first article ended by quoting Don Berwick of the Institute for Healthcare Improvement as saying “In the end, only those who provide care can improve that care.” In the second article, Tieman observed “If healthcare is indeed still mostly local, as many argue, federal directives aren’t as important as what communities, hospitals and even individual caregivers can do to improve.”
But all of that remains very tentative. On the matter of building community coalitions to improve care, Nancy Foster, senior associate director of policy at the AHA is quoted in the second article as saying “We don’t have any precise recommendations for hospitals right now.”
Well, I do. For starters, here are two things that a hospital’s Board of Trustees could do:
· Become informed about patients killed in its hospital due to medical errors and about malpractice claims filed against the hospital and hold its executive leadership accountable for reducing the incidence of both.
· Hold its executive leadership accountable for assuring that there are clinical protocols in the emergency room for treating strokes and heart attacks and that all physicians follow them.
Speaking of how to go about improving quality, Walter Ettinger, President of UMass Memorial Medical Center is quoted in Tieman’s second article as saying, “This is not rocket science.”
How true.
During the popularity of Total Quality Management in the 1980’s, the Ford Motor Company adopted the slogan Quality is Job One.
Quality is moving in that direction in health care, but the question seems to be not so much where it stands on the priority list, but whose job it is.
Jeff Tieman recently had two articles on this topic in Modern Healthcare. The first, in the January 5, 2004 issue, reported on the recently issued AHRQ (the HHS Agency for Healthcare Research and Quality) annual report on healthcare quality. After reviewing the contents of the report, Tieman concluded that “….who ultimately accepts responsibility for better quality – patients, hospitals, health plans or the government – is still undetermined.”
The second appeared in the January 20, 2004 issue. That one discussed the activities of the various national organizations that are attempting to promote improved quality in health care. In this case, Tieman concluded that “….there is no broad agreement on how the industry and its stakeholders should move forward and what the exact goals should be.”
There were nuggets in both articles, however, that suggested how all of this ultimately might get clarified. The first article ended by quoting Don Berwick of the Institute for Healthcare Improvement as saying “In the end, only those who provide care can improve that care.” In the second article, Tieman observed “If healthcare is indeed still mostly local, as many argue, federal directives aren’t as important as what communities, hospitals and even individual caregivers can do to improve.”
But all of that remains very tentative. On the matter of building community coalitions to improve care, Nancy Foster, senior associate director of policy at the AHA is quoted in the second article as saying “We don’t have any precise recommendations for hospitals right now.”
Well, I do. For starters, here are two things that a hospital’s Board of Trustees could do:
· Become informed about patients killed in its hospital due to medical errors and about malpractice claims filed against the hospital and hold its executive leadership accountable for reducing the incidence of both.
· Hold its executive leadership accountable for assuring that there are clinical protocols in the emergency room for treating strokes and heart attacks and that all physicians follow them.
Speaking of how to go about improving quality, Walter Ettinger, President of UMass Memorial Medical Center is quoted in Tieman’s second article as saying, “This is not rocket science.”
How true.
