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Advanced Quality Measurement
David B. Nash, MD, MBA, is the Dr. Raymond C. and Doris N. Grandon professor of health policy, and chairman, Department of Health Policy at Jefferson Medical College. Here, Dr Nash mainly focuses on report cards in promoting public accountability. Referring to his own quest for reliable physician and hospital data before having spinal surgery, the author contends that information is key. But its quality is variable. Most medical staffs today, he believes, still do not appreciate the importance of measuring and improving the quality of medical care. The lecture focuses on public accountability for quality and particularly on the impact of report cards, which has been impressive; and on the accuracy of online healthcare web sites, which, in an estimated one-third of cases, are decidedly inaccurate. But once consumers are provided with information that is succinct and conveys a message of risk, not benefit, they will use it more effectively, says Dr Nash, who goes on to note that consumers have a critically important role to play in improving their own safety … and describes the JCAHO’s dramatic new public accountability program titled New Pathways. The Shared Vision – report cards that will publish specific outcomes information. The author believes that, in the future, report cards must be seen by users, as being salient, reliable, and worth the effort. Health plans, in turn, must be convinced that good performance by doctors and hospitals should be rewarded and poor performance penalized. He concludes that patient safety involves acknowledgment, differentiation, innovation and reward. Without appropriate financial incentives, Nash adds, no quality improvement will really work. Moreover, the work of improving medical quality must begin with medical students. |
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