Bethesda, MD --A new Health Policy Brief from Health Affairs and the Robert Wood Johnson Foundation examines the ongoing need to improve the quality and safety of health care provided in the United States. Despite some progress toward goals set a decade ago following two landmark Institute of Medicine studies, the nation faces considerable challenges in making health care safe; effective; efficient; patient-centered; delivered on a timely basis; and devoid of ethnic, racial, and other disparities.
This policy brief explains how health care quality is commonly defined; examines the issues around measuring it; highlights some recent findings on quality improvement efforts, and discusses the key challenges still to be overcome. The policy brief is a companion to Health Affairs' April issue, "Still Crossing The Quality Chasm."
The brief includes the following:
- Despite improvements in recent years, health care in the United States is not as safe as it could be. A study published in Health Affairs suggests that during the care of one in three patients admitted to hospitals, a medical error occurs. And about 40 surgeries are performed each week on the wrong patient, or the wrong site of the patient's body, according to the Joint Commission, the organization that accredits health care organizations.
- Efforts have been made over the past decade to set standards, create checklists, and adopt other techniques to reduce medical errors and improve the quality of care being delivered. Many have paid off--for example, lower rates of bacterial and fungal infections that get into the bloodstream through catheters, ventilators, or other equipment used in hospitals and health care settings.
- Provisions in the Affordable Care Act are aimed at jumpstarting quality improvement efforts. For instance, starting in 2013, hospitals where readmission rates for patients with heart failure and other ailments exceed a particular target will be financially penalized under Medicare; conversely, those who perform better than expected will receive financial incentives.
- More needs to be done. Patients need to play a greater role in evaluating the pros and cons to determine the optimal course of their own health care. As Floyd Fowler and colleagues write in the current issue of Health Affairs, "High-quality medical decisions require that patients be fully informed and involved in the decision-making process." And hospitals and other health care organizations need to become "high reliability" organizations, with performance and safety standards set as high as other industries, such as aviation.
Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears each month in print, with additional Web First papers published weekly at www.healthaffairs.org.
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