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.
Quest for quality
Improvements must come from private-public collaboration
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.
Chip Kahn is president and CEO of the Federation of American Hospitals.
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