HEALTH CARE QUALITY: Comprehensive Effort Urged
A consensus statement published in this week's Journal of the American Medical Association urges health care professionals to focus on the "urgent need to improve health care quality." The statement was drafted by the National Roundtable on Health Care Quality, a panel of 20 public- and private-sector representatives convened by the National Academy of Sciences' Institute of Medicine. After meeting six times between February 1996 and January 1998, the panel reached several key conclusions:
- "The quality of health care can be precisely defined." The panel notes that quality measures often "have the same degree of accuracy as the majority of measures used in clinical medicine to make vital decisions about patient care."
- The current health care system is plagued by problems of "underuse," "overuse" and "misuse" of services. The panel notes that these problems exist in "managed care and fee-for-service systems ... in small and large communities alike, [and] in all parts of the country."
- Quality improvement efforts "are sporadic at best ... typically limited to single, large institutions, usually hospitals." According to the panel, "[l]ong-term, multi-institutional quality improvement programs are infrequent, and regional attempts to improve quality across an entire delivery system are very rare."
The consensus statement concludes that "a major, systematic effort to overhaul how we deliver health care services, educate and train clinicians, and assess and improve quality" is needed to correct current flaws in the health care system. The panel urges "health care professionals ... [to] take the lead in improving quality, and it strongly urges leaders in the health care professions as well as practicing clinicians to actively do so." In a strongly worded conclusion, the panel argues that the failure to improve quality poses a "staggering" burden to health care in the U.S. -- "The challenge is to bring the full potential benefit of effective health care to all Americans while avoiding unneeded and harmful interventions and eliminating preventable complications of care. Meeting this challenge demands a readiness to think in radically new ways about how to deliver health care services and how to assess and improve their quality. Our present efforts resemble a team of engineers trying to break the sound barrier by tinkering with a Model T Ford. We need a new vehicle or, perhaps, many new vehicles. The only unacceptable alternative is not to change" (9/16 issue). Click here to view an abstract of the panel's findings. This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.