It’s good to have a plan.

In late March, the U.S. Department of Health and Human Services unveiled their plan to improve safety and quality by creating a set of national goals and priorities to direct the nation’s healthcare industry. The National Strategy for the Quality Improvement of Health Care was mandated by the Affordable Care Act and crafted with input across the many HHS departments and from public comment from more than 300 groups, organizations and individuals representing all facets of the healthcare industry and the general public.

Carolyn Clancy, MD, director of the Agency for Healthcare Research Quality, was closely involved in the creation of the National Quality Strategy along with her colleagues from the Centers for Disease Control, Centers for Medicare & Medicaid Services, Office of the National Coordinator for Health Information Technology, and others. “All of these entities touch quality in many ways,” she said. “It’s an incredible opportunity we have with ACA to literally set a path for the nation.”

She added, “The Affordable Care Act builds on our current healthcare system, which means there is a strong working collaboration with pubic and private sectors.” Clancy pointed out the National Quality Strategy mirrors that collaborative spirit both in terms of how it was created and in how it envisions aims and priorities being met by stakeholders. Clancy was quick to say, however, that the National Quality Strategy does not set forth implementation mandates. “We’re not dictating the ‘how’ in any of this,” she explained. Instead, Clancy continued, the document outlines the goals that matter to people. “How you get there … that’s where we need to see a lot of innovation. This is not a ‘one size fits all’ anything.”

The plan has three broad aims:

1.      Better Care: The goal is to improve the overall quality of care by making healthcare more patient-centered, reliable, safe and accessible.

2.      Healthy People/Health Communities: The hope is to improve the health of the nation by supporting proven interventions to address behavioral, social and environmental determinants of health. This goal speaks to primary prevention and to chronic disease management.

3.      Affordable Care: Offering quality healthcare for individuals, families, employers and government is the third overarching goal. “I think everyone knows we have a cost problem,” Clancy said wryly.

To achieve these broad aims, the National Quality Strategy sets forth six key priorities on which to initially focus. Clancy outlined the rationale behind each.

• Making care safer by reducing available harms is the first priority point. Clancy said this point goes toward reducing medication errors, hospital acquired infections and other avoidable safety and quality issues that could be addressed through evidence-based best practices.
• The second priority is to ensure each person and family is engaged in their care. This point speaks both to making consumers more involved in the care they consume and to the overall experience of care. “A patient’s experience with care is now considered an indicator of quality,” she noted. Clancy also added that this is a difficult one to achieve and would require time and a coordinated effort.
• Clancy said priorities three and four really go hand-in-hand. The third key point is to promote effective communication and coordination of care. While electronic health records (EHR) certainly make this easier, Clancy said it is possible to achieve coordinated care without them.
• The fourth priority is to promote the most effective prevention and treatment practices for the leading causes of mortality, starting with cardiovascular disease. Clancy noted that knowing the best practices and actually implementing them consistently are too often at odds with each other. Again, clinical decision support that is central to many EHRs could be an effective tool to help meet this goal.
• The fifth priority is to work with communities to promote the wide use of best practices to enable healthy living. This, Clancy said, calls for tapping into community resources that already exist and looking at collaborative efforts.
• Finally, the last key point is to make quality healthcare more affordable through the development and implementation of new delivery models.

The good news, Clancy said, is that there is wide consensus on the need to improve quality and the will to implement innovative ideas to do so. “This isn’t a wild-eyed idea that someone is forcing on us. Since the Institutes of Medicine reports, people have realized there is a gap between the care we want to provide to patients and the care that is given, and people are very anxious to close that gap.” She added that for the past two decades there has been a national desire to assess and improve quality and safety. “The entire movement has built up steadily but incrementally.”

Clancy pointed out, “People often say we need to work together. If you don’t actually have a clear rationale and reason for doing that … it’s not that it has no point … but it’s hard for it to be much more than small talk.” With a strategy in place, the hope is that a national conversation on quality and safety will result in lasting improvements to the healthcare system.

Tags:

Related:

Bookmark:

Digg

Facebook

Technorati

Newsvine

Google