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Effective Practices In Improving The Quality Of Healthcare

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Millions of patients and their families place their lives in the hands of medical professionals on a daily basis. These medical events range in severity from a simple cut or sprain to a major surgery and everything in between. Although many people view medical facilities as safe and free of risk, that is not the case. The quality of healthcare that the average patient receives is usually exactly what they were expecting and to the best of the physicians ability. However, there are times when errors or mistakes are made that result in serious complications. Unfortunately, many people experience a problem and it sometimes leads to death or serious injury. In May 2005, Elizabeth Weiss wrote, "As many as 98,000 Americans still die each year because of medical errors despite an unprecedented focus on patient safety over the last five years, according to a study released today."1 This is not the only source that exhibits such a large number. "The mortality resulting from medical errors each year in the United States is estimated to be between 44,000 and 98,000--accounting for more deaths than from motor vehicle crashes, breast cancer, or acquired immunodeficiency syndrome."2 These staggering statistics have driven the American medical industry (hospitals, nursing homes, doctor's offices, etc.) and the patients they treat to focus their efforts on improving the quality of their services. It is important for patients to be educated about their medical needs and the costs associated with them. It is equally important for medical professionals to observe the importance of providing quality care. The possibilities of medical mistakes are endless, but there are specific tools available to help improve the quality of healthcare in our country and around the world.

Many sources categorize healthcare quality problems into one of three categories: underuse, overuse, and misuse. The Institute of Medicine's National Roundtable on Health Care Quality was a gathering of experts and industry professionals. They published an article in the Journal of the American Medical Association which provided a more in depth look at these three groups. "Underuse is the failure to provide a health care service when it would have produced a favorable outcome for a patient."3 The report provides the example of a child missing an immunization for an easily preventable disease. Missing such an immunization would leave a child vulnerable to illnesses that could eventually lead to their death or serious disability. "Overuse occurs when a health care service is provided under circumstances in which its potential for harm exceeds the possible benefit."3 To make that description more clear, the report cites the prescribing an antibiotics for a viral infection that antibiotics are ineffective in fighting. By prescribing such an ineffectual treatment, the patient would be at further risk. "Misuse occurs when an appropriate service has been selected but a preventable complication occurs and the patient does not receive the full potential benefit of the service." 3 For example, preventable complications of surgery, errors or mistakes, and incorrect medication use are important misuse problems. Even though these categories help to simplify the understanding of quality problems in healthcare, they do not begin the arduous task of correcting them.

What happens when the quality of healthcare results in errors? Like many things, the results of quality problems can be viewed on a spectrum. On one side, patients experience minor problems or obstacles. For example, if a patient receives a drug that is innocuous or mild enough to avoid serious complications. On the other side, however, are the more serious consequences. These consequences could include allergic reactions, extended hospital stays, and even death. The Washington Post offers one example. "Jessica Santillan died Saturday at Duke University Medical Center, surrounded by an arsenal of medical technology, top doctors, and a network of experts dedicated to transplanting her with organs that could save her life. None of these measures, however, protected her from a misunderstanding between her doctor and a North Carolina organ bank. As a result, mismatched organs were transplanted into the 17-year-old and, despite heroic measures and a second transplant, she died."4 To put these examples into a perspective that most people will be able to relate to, the following article printed in Harvard Business Review may be helpful. "The Center for Disease Control and Prevention (CDC) estimates that for each person who dies from an error or infection, five to ten others suffer a nonfatal infection. With approximately 33.6 million hospitalizations in the United States each year, that means as many as 88 people out of every 1,000 will suffer injury or illness as a consequence of treatment, and perhaps six of them will die as a result."5 It should be obvious, then, that the quality of healthcare should be at the forefront of concerns for most Americans.

Believe it or not, many quality problems can be avoided if patients and their families would take a more active role in their own medical care. Liz Szabo offered readers eight ways to increase their chances of receiving the best treatment. Her suggestions included, but were not limited to: bringing an advocate who will speak for you, preparing a health profile that will provide healthcare professionals with important medical information, avoiding surgery on the wrong site by being actively involved in the discussions and labeling of the site(s), and educating yourself on your condition, medication(s), and procedure(s).6 In the end, however, it is the responsibility of the medical establishment and its personnel to ensure that the quality of their services meet the high standards required to maintain a healthy and safe environment.

Some sources claim that progress and effort toward correcting quality problems is minimal or nonexistent. For example, The Committee on the Quality of Health Care in America, appointed by the Institute of Medicine in 1998, stated in their report that "What is perhaps most disturbing is the absence of real progress toward restructuring health care systems to address both quality and cost concerns, or toward applying advances in information technology to improve administrative and clinical processes."7 These claims, although made almost ten years ago, can now be argued with the efforts being made by several levels of government and organizations. This is because there are numerous tactics being used to improve quality problems in healthcare at the national, state, and local levels. They aim to ensure that patients and other healthcare customers receive the best care possible while still allowing the healthcare industry the freedom it needs to operate.



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