A Voice from the Field

• 3/11/2010
• Author: Audrie Bretl Roelf
• Category: Benchmark Blog
• 13907 Views
• 0 Comments
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I try as much as I can in Benchmark to include columns from those in The Joint Commission who know the real scoop on performance measurement and improvement. In the May/June issue, I will include a column from Jerod M. Loeb, Ph.D., executive vice president, Division of Quality Measurement and Research. It’s called “Performance Measurement: The Good, Bad, and The Ugly,” so you know he’s got some good stuff to say. Here’s a sample of what’s to come:

The reality that most of us appreciate in health care today is that we tend to live in a culture of low expectations. Data have repeatedly shown that, in the United States, about 40 cents of each health care dollar spent is wasted. Even when available, health care organizations fail to use technology to empower themselves and their patients. There is only limited use of electronic health records, little interoperability among extant automated systems (that is, administrative, pharmacy and clinical decision support come to mind here) and workarounds are developed for inefficient processes, rather than redesigning the process. And, we live in an environment in which many toxic processes often defy logic. Changing the oil on a 747 aircraft at 35,000 feet is probably easier than changing existing systems and processes in health care today.

With these obstacles in mind, it is interesting to consider the various barriers to implementing evidence-based quality and safety practices that need to be overcome. While this list is certainly not exhaustive, what comes to mind are the following:
• Absence of organizational culture focusing on quality and patient safety
• Lack of knowledge and experience in systems-thinking including systems analysis and process redesign
• Lack of availability of practical tools and solutions to guide implementation of specific practices
• Lack of effective methods for creating a behavior change among health care professionals
• Tendency to add specific evidence-based practices to existing chassis rather than redesign the process

You won’t want to miss reading this issue. Along with Dr. Loeb’s column, I’ll have articles on electronic health records, human error reduction, the patient-centered medical home, and more. Be sure to check it out when it arrives in mid-April.

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