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AAMC Spearheads New Quality Initiative State Budget Cuts Put Strain on Teaching Hospitals Innovations in Medical Education: "Communicating in Other Ways" "A Shot in the Dark": the smallpox vaccination program Viewpoint: Women in Medicine: The Work that Remains A Word from the President "A Day in the Life of a Medical Student"
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AAMC Spearheads Initiative On Quality Patient, Hospital CareThe AAMC, along with the Federation of American Hospitals (FAH) and the American Hospital Association (AHA), is leading an effort to create a framework for developing and reporting evidence-based standardized hospital quality measures. Accrediting organizations, quality and consumer groups, and government agencies have announced their support for this initiative. "This quality initiative addresses the need for a uniform national model of reporting," said George Sheldon, M.D., past chair of the AAMC and professor and chair of the department of surgery at UNC-Chapel Hill, at a Dec. 12 press conference to launch the initiative. "While many different studies of quality and adverse event reporting are available, our members have been disadvantaged by a diverse methodology that precludes comparison," Dr. Sheldon said. FAH President Chip Kahn said that this effort is particularly welcome to hospitals because it gives them standardized "rules of the road" for reporting on performance. "Up to this point, hospitals were being pushed and pulled in different directions regarding performance, and these overlapping requirements take time and resources away from patient care," Kahn said. Ten measures, three conditionsThe initiative will encourage hospitals to provide the public with information on 10 quality performance measures for three conditions: acute myocardial infarction, heart failure, and pneumonia. These measures are endorsed by the National Quality Forum, a non-profit public benefit corporation created in 1999 to standardize healthcare performance measures and to develop and implement a national strategy for quality measurement and reporting. The initial set of 10 measures will enable hospitals to standardize the information so that it is relevant for clinicians in their quality improvement efforts, and for consumers as they attempt to make informed healthcare decisions. "There remain significant challenges to achieving a full-blown national program to provide useful performance information about hospitals," said Dennis O'Leary, MD, president of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). "The major hurdles include arriving at a set of relevant, standardized measures; the ability to translate measure data into reliable, meaningful information; designing workable, helpful consensus on which measures should be publicly reported; reaching agreement on the formats for reporting such information; and making sure that hospitals have sufficient computer resources to support the collection of accurate, reliable data," Dr. O'Leary said. CMS to be involvedHealth and Human Services Secretary Tommy Thompson, also present at the conference where the voluntary efforts were announced, applauded the nation's hospital leadership for the initiative and called on hospitals throughout the nation to participate in the voluntary effort. At the same time, he announced steps HHS will take to help develop and refine quality measures for hospitals, including a standardized patient experience survey instrument and a three-state pilot project in Maryland, New York, and Arizona. Conducted by the HHS's Centers for Medicare & Medicaid Services (CMS) with the Quality Improvement Organizations in each state, the pilot project will test the most effective ways to communicate with consumers about hospital quality of care. "As hospitals undertake this solid first step in public quality reporting, we want to help them determine how to make this data most helpful," said CMS Administrator Tom Scully. "Our pilot project will measure the real-world impact of the 10 initial quality measures announced today." HHS's Agency for Healthcare Research and Quality is working with experts in the healthcare industry to develop a standardized patient experience survey, known as H-CAHPS, that can be used to compare experiences at different hospitals. The new standardized format will also be tested in the new three-state pilot project. The voluntary effort addresses all three of the AAMC's missions: health care, research, and medical education, Dr. Sheldon pointed out. "As care providers to many of the nation's most severely ill patients, teaching hospitals are committed to establishing reliable and understandable national quality measures that will assist patients and their families in making informed decisions about the care they and their loved ones receive," he said. As major centers for medical research and technology, teaching hospitals are often where quality measures are developed and tested, Dr. Sheldon continued. "This initiative will build a structure that will help disseminate this research, which is so critical to quality improvement and patient safety." Finally, this effort will help teaching hospitals maintain the already strong connection between the medical education environment and quality assessment, so that institutions can instruct tomorrow's doctors on ways to provide the safest medical care to future populations, Dr. Sheldon said. Although excited about the prospects of this initiative, most healthcare leaders agree that this is just the beginning of a long and complex process. "We believe that [AAMC] members will view this national collaboration as the essential first step as they advance their commitment to superior health care, and we are already working to encourage full participation in this voluntary effort," said Dr. Sheldon. "Through our commitment to this long-term comprehensive initiative, we can continue to strengthen the public's trust in the care they receive - job one for every healthcare provider," he added. -Suria Santana, ssantana@aamc.org |
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