The enormous challenges facing the nation's hospitals are about much more than the workforce shortage, economic survival and keeping the quality of care and community service high.
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Tough questions about patient care quality and safety are coming at us from every direction. More than at probably any time in our history, we are under pressure to be more proactive and accountable to the public about how we define and measure quality.
Government health agencies, private accrediting groups, insurers, and large businesses, among others, are asking tough questions about the quality, appropriateness and value of the care we provide. And many aren't willing to wait long for answers. They've taken it upon themselves to get access to hospital data, and then calculate and report -- often in the form of scorecards or report cards -- statistics that offer a limited and possibly misleading picture of the quality of care. In other words, they are trying to tell our story about quality.
Hospitals have a powerful story to tell about how we strive for safer, more effective care and we must be a more forceful part of the move to bring better quality data to the public. The fact is, hospitals are doing far more than most people realize.
Many hospitals are pioneering new techniques to improve quality and safety, borrowing ideas from other fields and finding out which safety practices work well and how they can be improved. They are using advances in technology to improve patient safety and quality. And they are constantly studying clinical indicators and measures of quality as the building blocks for improvement.
Hospitals should and can be in a leadership role in talking about quality and sharing information. The more accountable we can be, the greater the level of public trust and confidence we will earn from the communities we serve.
What we must avoid, however, is contributing to the public's already considerable confusion about what constitutes quality and what information they should rely on.
Today, many national organizations are attempting to measure and report on the quality of hospital care.
But their efforts are moving forward with little or no coordination of strategies, goals or standards. Without a shared national agenda that includes the active leadership of the hospital community, these activities will only lead to conflicting or misleading data, a duplication of efforts, unnecessary reporting and regulatory burdens on hospitals, and a public still demanding clear, consistent, and accurate information.
The AHA, the Federation of American Hospitals, and the Association of American Medical Colleges want to bring clarity to the quality measurement process. We have been working with the Centers for Medicare & Medicaid Services, the National Quality Forum, the Agency for Healthcare Research and Quality, and the Joint Commission on Accreditation of Healthcare Organizations, to see if we can forge a common agenda for responding to the demand for getting credible information to the public.
What do we hope to achieve? To keep the focus on consistency, logic, and coordination -- through, for example, greater use of standardized measures -- as we strive to get useful information about our performance to the public, and to foster continual quality improvements among hospitals.
Through this process, we hope to find the answers to questions that can help hospitals strengthen their public accountability: How do we make sure the information provided to the public is accurate, comparable, and meaningful? How do we make sure that we are not just measuring quality, but also giving hospitals information that can help them improve the process of care? And how do we make the public aware not only of what we are measuring, but also of how we are improving?
The quest for quality is not a goal that's reached; it's a never-ending process of learning, doing and changing. Quality measurement must be about the values that underpin that quest.
You have so much to be proud of ... your commitment to improving quality and patient safety should serve as a powerful reminder to your community of how the laying on of skilled hands, reinforced by the power of the heart and mind, carried out in the finest ethic of curing and caring, makes our hospitals the special places they are.
Davidson is president of the AHA.
