DIY HEALTHCARE SYSTEM: What is quality in healthcare?

Posted on Wed, Dec 10, 2014
DIY HEALTHCARE SYSTEM: What is quality in healthcare?


“You all are in the cat bird’s seat. Because you are in the hospital most of the time and in the ED particularly, the common pathway for entry into the hospital, you know what’s going on better than anyone else. You are in the best position to implement change. You are in the right spot at the right time. Our country needs your help.” With those words, David Nash, MD, MBA, dean of the Jefferson School of Population Health at Thomas Jefferson University in Philadelphia, opened EmCare’s 2014 annual conference with his presentation entitled, “Population Health & Quality in the New World of Health Reform.”

Dr. Nash, an accomplished educator and author, was instrumental in founding the country’s first school of population health. A board certified internist, Dr. Nash is passionate about the need to reform America’s healthcare system.

He divided his presentation into five parts:

How did we get into this jam?
What is quality in healthcare?
What’s population health, anyway?
What is health reform and what’s its special connection to quality, safety and accountability?
What’s in the future?

Over the next few weeks, we’ll post key takeaways from Dr. Nash’s presentation.

What is quality in healthcare?

The IOM defines quality as "The degree to which health services for individuals and population increase the likelihood of desired health outcomes and are consistent with current professional knowledge." The IOM’s sentinel report To Err Is Human, Building A Safer Health System was issued in 1999. It shone a harsh light on the safety, quality and cost issues plaguing the US healthcare system. The headline-grabbing fact to emerge from the report was that American hospitals kill more than 90,000 patients annually. The report precipitated an avalanche of media attention. Consumer Reports gave the US health system a "D" on reducing medical errors. The Wall Street Journal carried a lead story with the blaring headline "Unaccountable Care, How to Keep Hospitals from Killing Us." And Time Magazine joined the fray with a cover story "What Doctors Hate About Hospitals."

In the face of mounting criticism and pressure, a variety of healthcare associations and groups announced quality and cost improvement initiatives. The American Medical Association announced its Top 10 Ways To Improve Patient Safety. And the IOM published its follow-up report Crossing the Quality Chasm, A New Health System for the 21st Century. The report focused on six domains, or key dimensions, of the healthcare delivery system: safe, effective, patient-centered, timely, equitable and efficient. This is the core framework for where the nation’s healthcare system needs to go.

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