Quality Improvement in Hospital HealthCare

This paper looks at quality improvement in hospital healthcare in the United States and what is being done to promote it. It first discusses the contributions of Malcolm Baldrige in his establishment of methodologies for quality improvement, then looks at the efforts of Quality Improvement Organizations (QIO) and the Centers for Medicare and Medicaid Services (CMS) to develop unified systems of quality care reporting by hospitals which is standardized nation-wide. Some of its achievements are noted and plans for the future discussed. The paper also examines a study which looked at healthcare quality improvement in hospitals from 1998-1999 to 2000-2001, and its findings and suggestions for the future. The paper finally looks at the problem of surgical infections, for which efforts are underway to enforce nationwide compliance with a set of standards to reduce the death rate from such preventable occurrences.

Malcolm Baldrige served as Secretary of Commerce from 1981 until 1987, when he died in a rodeo accident (Baldrige, 2001). His managerial expertise is credited with long-term improvement in the efficiency and effectiveness of government, and in developing methods which can help both manufacturing and service industries provide quality goods and services, while improving productivity, lowering costs, and increasing profits. The Malcolm Baldrige National Quality Award was created by Public Law 100-107 in 1987 to create a

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rmance and perfect performance. The study showed that the median state's improvement from baseline was improved for 20 of the 22 indicators (Hencks, Huff and Cuerdon, 2003). The percentage of patients receiving appropriate care on the median indicator in the median state increased from 69.5 percent to 73.4 percent, giving a relative improvement of 12.8 percent. The average relative improvement was 19.9 percent for outpatient indicators and 11.9 percent for inpatient indicators. Absolute improvement was greater in states with lower baseline performance than those with higher baseline performance except for one state. Ranked on each indicator, the state's averages were highly stable over time. The authors of his study concluded that care for Medicare fee-for-service beneficiaries improved significantly from 1998-1999 to 2000-2001, but that there is a much larger potential for improvement remaining (Jencks, Huff and Cuerdon, 2003). Relative rankings for states did not change significantly over this time. The improved care was thought to be consistent with QIO activities over this time, but there was no conclusive information about how much of the improvements measured could be attributed to QIO quality improvement

Category: Medical - Q