Quality health care means doing the right thing, at the right time, in the right way, for the right person—and having the best possible results. Although we would like to think that every health plan, doctor, hospital, and other provider gives high-quality care, this is not always so. Quality varies, for many reasons.

At no time in the history of medicine has the growth in knowledge and technologies been so great. New technologies offer the promise of increasing longevity, improving health, and alleviating pain and suffering. For several years, health care has been shifting from acute, episodic care to care for chronic conditions. Chronic conditions are now the leading causes of illness, disability and death. More than 40% of people with chronic conditions have more than one condition. This trend requires a more complete communication structure and coordination of care. Yet, physicians, hospitals and other health care organizations operate independently and often do not share information about the patient's condition, medical history, services provided in other settings, or medications prescribed. As medical science and technology have advanced, and patients have become more complex, the health care system has not been able to provide consistently high quality care to all Americans. Research on the quality of care shows that the health care system falls short in translating knowledge into practice, and applying new technology safely and in a timely manner. Many types of medical errors require additional health care services to treat patients who have been harmed. The health care system is fragmented and lacks the clinical information systems to prevent unnecessary duplication of services, long waiting times and delays in services. The health care system does not make the best use of its resources.

In response to these challenges, the Institute of Medicine has established six aims for improvement. The health care should be:

Safe – avoiding injuries to patients from the care that is intended to help them.

Effective – providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse)

Patient-centered – providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patients values guide all clinical decisions.

Timely – reducing waits and sometimes harmful delays for both those who receive and those who give care.

Efficient – avoiding waste, including waste of equipment, supplies, ideas and energy.

Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socio-economic status.

(Excerpt: Crossing The Quality Chasm, A New Health System for the 21st Century, Institute of Medicine, 2001, National Academy of Sciences.)

Quality Measurement

Fortunately, there are scientific ways to measure health care quality. These tools have mostly been used by health professionals. They use measures to review and improve the quality of care they provide. A quality measure is information from a patient's record or an operational process that is converted into a rate, percentage or time that shows how well providers are taking care of their patients. Quality measures give you information about how well providers care for some, but not all of their patients. Most quality measures have been designed to measure evidence based care. Patient who should not get the recommended care treatments are not counted in the measures.

Quality measurement is a relatively new science and requires a large amount of resources to develop and collect the information. Fully developed and tested measures are only available for reporting on some of the most common conditions or processes of care. Over the past few years, an increased interest in this science has occurred which may increase the rate of quality measurement development and reporting over time. But there is some quality information you can use right now to help you compare your health care choices. Many public and private groups are working to improve and expand health care quality measures. The goal is to make these measures more reliable, uniform, and helpful to consumers in making health care choices.

Reporting Leads to Improvement

Wisconsin hospitals are united around one concept: to improve patient care in the communities they serve. They also agree: you can't improve what you don't measure. That is why they have committed to measuring and publicly reporting their performance.