Monday, March 21, 2011

The National Quality Strategy

On Monday, I spent the day in Dallas with my High Reliability Steering Committee (HRSC) co-chair, Dr. Charlie H., and several of my Ascension Health colleagues. We discussed the progress we've made on the HRSC and reported on the data we've collected and safety alerts for the system. In particular, how can we do a better job in each of these areas to make them more effective and meaningful. There is so much we are doing and so much more we are trying to to to improve quality and safety throughout our system. The ongoing challenge includes finding key ways to engage and roll-our to 117,000 associates in addition to our many thousands of physicians, volunteers, patients and families. One quote I enjoyed by Dr. David P., "Don't let perfect be the enemy of good. Err on the side of safety." We know that our intention is good and we know there is much work that needs to be done. We also need to be mindful to take on what we can within the resources we have at the time.

After our discussion, I was encouraged to read the release on Monday from the U.S. Department of Health and Human Services (HHS) released the National Strategy for Quality Improvement in Health Care (National Quality Strategy). In many ways, we've said some of the same things in a different way - improve the health of your community by delivering high quality care in a cost effective manner.

According to the release, the strategy was called for under the Affordable Care Act and is the first effort to create national aims and priorities to guide local, state, and national efforts to improve the quality of health care in the United States.

The National Quality Strategy will promote quality health care that is focused on the needs of patients, families, and communities. At the same time, the strategy is designed to move the system to work better for doctors and other health care providers – reducing their administrative burdens and helping them collaborate to improve care. The strategy presents three aims for the health care system:

  • Better Care: Improve the overall quality, by making health care more patient-centered, reliable, accessible, and safe.
  • Healthy People and Communities: Improve the health of the U.S. population by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care.
  • Affordable Care: Reduce the cost of quality health care for individuals, families, employers, and government.

To help achieve these aims, the strategy also establishes six priorities, to help focus efforts by public and private partners. Those priorities are:

  • Making care safer by reducing harm caused in the delivery of care.
  • Ensuring that care engages each person and family as partners.
  • Ensuring that each person and family are engaged as partners in their care.
  • Promoting the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease.
  • Working with communities to promote wide use of best practices to enable healthy living.
  • Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.

The National Quality Strategy is just one piece of a broader effort by the Obama Administration to improve the quality of health care, and will serve as a tool to better coordinate quality initiatives between public and private partners. For example, the Affordable Care Act established a new Center for Medicare and Medicaid Innovation that will test innovative care and service delivery models. These new models are being tested to determine if they will improve the quality of care and reduce program expenditures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

Many of us already have things in place to address many if not all of these areas. What are your thoughts on the release? How will it change things in your organization?

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