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STUDY TO EXAMINE RESULTS, PROGRESS SINCE INSTITUTE OF MEDICINE’S CROSSING THE QUALITY CHASM
The Institute of Medicine’s seminal report, Crossing the Quality Chasm called for overhauling the way health care is delivered in the United States, suggesting a redesign to become better able to deliver care that is safe, effective, timely, patient-centered, efficient and equitable to all. Numerous public and private organizations heeded this call by developing and supporting broad-based quality improvement and patient safety initiatives. This survey is studying those initiatives and the results, in addition to hospital executives and front-line clinicians’ perspectives on quality, to determine progress made since the study’s publication. Funded by a $326,195 grant from the Commonwealth Fund, the project began September 1st and will conclude November 2006. “It is widely known that our country is experiencing a health care system crisis,” said BU School of Management Professor Joseph Restuccia, Dr. P.H. who is lead co-investigator of the survey, “Our research should lead to the development of tools that hospitals can use to enhance the quality of their patient care while also achieving efficiency goals.” “This grant from The Commonwealth Fund will allow us to closely examine the patient care quality and efficiency improvements that are underway at U.S. hospitals, both objectively and through the eyes of clinicians, whose perceptions of the impact of improvements and of plans for the near future should be very revealing,” said fellow lead co-investigator Dr. Alan B. Cohen of the BU Health Policy Institute. Health Policy Institute staff, comprised of Drs. Cohen and Restuccia, and SMG Professor Michael Shwartz, in collaboration with the Health Research and Educational Trust, a research and education affiliate of the American Hospital Association, will design and conduct two complementary surveys in a sample of at least 500 hospitals organized by key characteristics such as bed size, census region, teaching status and ownership. Staff first will use the Hospital QI Activities Survey to document the nature and extent of QI efforts undertaken by hospitals, and to assess the importance of leadership, organizational culture, workforce strategies, and the use of information technologies. Staff then will use the Clinicians’ Perceptions of Quality Survey, which is based on a survey developed by a BU study team in an evaluation of the Robert Wood Johnson Foundation’s Pursuing Perfection program, to query at least 3,000 front-line physicians and nurses in the same hospitals regarding their assessments of the quality of care and the quality improvement activities taking place in their organizations. In addition, staff will use quality-of-care measures from the Centers for Medicare and Medicaid Services and from the Joint Commission on Accreditation of Healthcare Organizations, to analyze the relationship between quality improvement activities and quality of care. “This study is very timely, and results will help inform health care stakeholders about the types of quality improvement activities that hospitals are currently undertaking,” said Anne-Marie Audet, M.D., vice president for quality improvement and efficiency programs at the Commonwealth Fund. “More importantly, it should also shed light on which of these activities are associated with good performance, and thus provide insights into promising approaches and future areas for improvement.”
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