Over the past century, medicine has become increasingly complex with the development of new technology, equipment, medications, and multiple specialties involved in care. This has led to a system that is often broken, with an increased risk of errors and the potential to cause patient harm. This concept was first highlighted in a landmark report from the Institute of Medicine (IOM) published in 1999, To Err is Human: Building a Safer Health System. This report cited that between 44,000- 98,000 deaths occurred yearly from preventable medical errors. Since then other studies have also validated these numbers, including one that utilized the Institute for Healthcare Improvement Global Trigger Tool and estimated that the rate of patient deaths due to preventable medical errors was between 210,000 and 400,000. Although the numbers vary, the takeaway is that too many patients are being harmed by preventable medical errors and ultimately we need to do better.
Healthcare Quality Improvement Goals
The IOM went on to publish another important report in 2001, Crossing the Quality Chasm: A New Health System for the 21st Century, in which clearly defined recommendations for healthcare quality improvement were made. These include a focus on the following health care quality aims:
- Timely- pertains to patient evaluation and treatment. This includes reducing wait times, reducing delays in care for patients, and reducing delays in providing care to patients on the part of the providers
- Effective- Evaluation, and treatment based on scientific evidence. Also included in this concept is withholding services to those unlikely to benefit.
- Patient-centered– putting the patient at the center of our model of care, and thus taking into consideration the preferences, needs, and values of the patient in a respectful manner (shared decision making). For example, developing a plan of care that takes into consideration what matters to the patient with respect to the labor/birth process and combining this with evidence-based care and provider expertise.
- Efficient– avoiding waste. This includes equipment, supplies, ideas, and energy. For example, standardizing operating room equipment packs that include supplies routinely used versus those in which supplies are thrown out on a regular basis.
- Safe– reducing preventable harm to patients
- Equitable- providing the same high-quality care to all patients regardless of gender, ethnicity, socioeconomic status, and where they live.
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Ciesielski & Fraser. (2016). The Washington Manual of Patient Safety and Quality Improvement (E. Fondahn, M. Lane, A. Vannucci, Eds.). Wolters Kluwer.