Framing the Issues forQuality and Patient Safety

David J. Shulkin, M.D.Professor and Chairman

Chief Quality OfficerDrexel University School of Medicine

DrShulkin@aol.com

• “If you don’t know where you’re going , you’re liable to end up someplace else”

– Robert Mager

The Market Model for Quality St

ages

Stage 2 Stage 3 Stage 4

Acknowledgement Innovation RewardDifferentiation

Stage 1

Learning Organization

Goal Setting- DefectFree Hospital

System (process)Redesign

Culture Change

Staff Training/Education

Data Collection/Analysis

Preventive Risk Strategies

Leadership Attention

Organizational Assessments

Pro

vide

rR

esp

onse

Media Coverage

Consumer Interest

ConsumerActivation

Pay for Performance

Adoption of Technology

Employer Response(Leapfrog)

Legislation

Availability of Technology Solutions

Business Case for Quality/Safety

Regulatory Initiatives

Malpractice Crisis

Data Release (IOM Report)

Mar

ket

Rea

ctio

nsD

rive

rs

Stage I- Acknowledgment

“All I know is what I read in the newspapers.”

- Will Rogers

According to a recent Survey respondents had the following concerns:

61 % being given the wrong medicine

58% given medicines that interact in a negative way

56% complications from a procedure

American Society of Health System Pharmacists

Concerns About Safety

Acknowledgment

• Harvey Fineberg- President of IOM

• Arthur Miller- Harvard Law Professor, Author, and TV host

Stage II- Differentiation

Differentiation

• Suzzane Delbanco- Executive Director, The Leapfrog Group- Purchaser Initiatives for Quality and Error Reduction

Stage III- Innovation

Technology- Are We Doing All We Can?

• 92% of Providers believe much more can be done for quality than is being done

• Effectively using technology: 16%

• Federal efforts required: 44%

VHA Survey, Attendees at International Patient Safety Symposium, 2001

Innovation

• George Halvorson- Chairman and CEO, Kaiser Foundation Health Plan, Author “Strong Medicine and Epidemic of Care”

Stage IV- Reward

“It is hard to get someone to understand something when his salary depends on him not understanding it.”

You can always trust the You can always trust the Americans. In the end they Americans. In the end they will do the right thing, after will do the right thing, after they have eliminated all other they have eliminated all other possibilities.possibilities.

- Sir Winston Churchill- Sir Winston Churchill

Are We Really Making Progress in Patient Safety?