It has been more than 20 years since the Institute of Medicine—now known as the National Academy of Medicine, published “To Err is Human: Building a Safety Health System¹” and “Crossing the Quality Chasm: A New Health System for the 21st Century².” These seminal “call to action” reports brought significant and much needed attention to the issues of patient safety and health care quality in the United States. One of the most important and enduring contributions of “Crossing the Quality Chasm” was the identification of six specific aims that have since become the essentials of health care quality. Health care should be safe, timely, effective, efficient, equitable, and patient-centered.   

• Safe: Avoiding harm to people for whom care is intended. 
• Timely: Reducing wait times and eliminating delays that do not provide information or allow time to heal.   
• Effective: Providing evidence-based health care services to all patients who could benefit. This also refers to refraining from providing services to those unlikely to benefit from them.  
• Efficient: Maximizing the benefit of available resources and avoiding waste. 
• Equitable: Providing care that does not vary in quality on account of gender, ethnicity, geographic location, or socioeconomic status.  
• Patient-Centered: Providing care that is respectful of and responsive to individual preferences, needs, and values.   

These aims are well represented in the mission, vision and core values of UI Health Care. They also serve as an important and consistent framework for all of us as we engage in ways to make our health care system better.     

Each year, the Quality Improvement Program (QuIP) identifies several issues that are deserving of focused quality improvement efforts. For fiscal year 2022, we chose to continue efforts on reducing hospital acquired conditions and improving our end-of-life care services. The rationale for focusing on these two areas is that it both aligns with a goal of delivering STEEEP care (i.e., health care that is safe, timely, effective, efficient, equitable, and patient-centered) and may also have a high impact on our publicly reported metrics and pay-for-performance programs.   

QuIP has engaged multidisciplinary performance improvement teams that are working to reduce surgical site infections (SSI) related to colon procedures (colon SSI), surgical site infections related to cesarean sections (cesarean section SSI), central line-associated bloodstream infections (CLABSI) and hospital-acquired pressure injuries (HAPI). We also have a team focused on improving the ways we identify patients with serious illnesses and patients who are potentially near the end-of-life who may benefit from supportive care, palliative care and/or hospice care services so that we can offer those services sooner.   

In each of the subsequent Quest monthly newsletters, we are going to highlight one of the FY22 Quality & Safety Initiative Projects so you can learn in greater detail what we have been doing to improve the quality of care we deliver here at UI Health Care.  

— Derek Zhorne, MD, Interim Chief Quality Officer 

References 

¹  Institute of Medicine (US) Committee on Quality of Health Care in America, Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To Err is Human: Building a Safer Health System. National Academies Press (US). 

²  Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).