Framing the Issues forQuality and Patient Safety
David J. Shulkin, M.D.Professor and Chairman
Chief Quality OfficerDrexel University School of Medicine
• “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?