Challenges in Healthcare Quality

The debate on healthcare reform is one that is familiar to most. The constant push to improve patient care has been the main goal of quality management. Throughout the history of the debate, however, quality management has never been given as much attention before the Institute of Medicine (IOM) publications of both Crossing the Quality Chasm: A New Health System for the 21st Century and To Err is Human: Building a Safer Health System. The reports identified various systems which must be implemented to decrease the number of medical errors and improve patient care in the United States. 

Proposals in the IOM Reports

One of the most important changes which the IOM proposes is to implement safety systems in healthcare organizations to ensure safe practices at the delivery level. As it stands today, the United States healthcare system lacks consistent and high-quality medical care for its population.  In the 1999 publication from the IOM To Err is Human, it was found that between 44,000 to 98,000 people die in hospitals each year as a result of medical errors which could have been prevented. This number has not improved; in fact, the statistics are even more shocking today.

The Journal of Patient Safety (2013) indicates that the IOM statistics, a result of nearly three decades of data, was actually grossly underestimated. New research indicates that medical errors are responsible for between 210,000 to 440,000 deaths every year in the United States. Such statistics seem to be in direct contradiction to the very purpose of healthcare organizations: to provide safe and efficient healthcare to the general population. 

Another important proposal in the IOM report is, to identify and learn “from errors by developing a nationwide public mandatory reporting system and by encouraging healthcare organizations and practitioners to develop and participate in voluntary reporting systems” (IOM, 1999). I believe that this proposal is crucial to the improvement of the healthcare system, and we have seen a serious effort to implement such policies.

Such policies have been in direct correlation with the IOM report as they proposed hospitals and other healthcare organizations report on both effective and ineffective practices for other healthcare organizations to take notice. According to studies, recent healthcare plans led to a more effective environment for comparative research, reviews, and implementation of evidence-based methods of care (Hughes, 2011). 

Challenges in Implementation

Challenges in healthcare reform are certainly many. For the purposes of our discussion, we will discuss the two proposals which were discussed by the IOM. First, the implementation of safer measures in healthcare organizations has seen many challenges. Evidence of a growing number of deaths since the publication of the IOM report indicates that the United States healthcare system has not made a considerable effort to address the concern of patient safety. The implementation of evidence-based medicine, on the other hand, has seen some level of success. According to Becker’s Hospital Review (2011), many hospitals and healthcare organizations have implemented effective and thorough evidence-based medicine into their methods of care. Some of the challenges, however, are maintaining full and thorough updates of evidence-based care and the technology needed to provide the clinicians with those data. Although these challenges exist, the will to move towards evidence-based care is widely supported with optimism throughout the healthcare community (2011). 

Despite the thorough and convincing reports published by the IOM, we have yet to significantly address the major concerns of healthcare in the United States. Although healthcare organizations, policymakers, and other stakeholders have been working towards a better healthcare system, more needs to be done. Needless to say, a safer healthcare system should (and can) be implemented with the will and effort of the major stakeholders. Furthermore, evidence-based medicine is also possible; and is actually within reach. 

References

Herman, Bob (2011). Evidence-Based Medicine: The Present and Future of Hospital Care. Becker’s Hospital Review. Retrieved: 10 January 2016.http://www.beckershospitalreview.com/quality/evidence-based-medicine-the-present-and-future-of-hospital-care.html

Hughes, GB (2011). Evidence-Based Medicine in Healthcare Reform. National Institutes of Health. Retrieved: 10 January 2016.http://www.ncbi.nlm.nih.gov/pubmed/21860057 

James, John (2013). A New, Evidence-Based Estimate of Patient Harms Associated with Hospital Care. Journal of Patient Safety. Retrieved: 10 January 2016.http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx

Varkey, P. (2010). Medical quality management: Theory and practice. Sudbury, MA: Jones & Bartlett.