Читать книгу The Quality Improvement Challenge - Richard J. Banchs - Страница 15

In the last 20 years, science has made a number of transformational changes that have impacted the way we think about healthcare. Targeted cancer therapy, drug‐eluting cardiac stents, 3D printing, and the human genome project are but a few of the advances that have revolutionized medicine. Yet how we deliver care and the healthcare experience have not improved at the same rate. Despite significant efforts, regulatory mandates, and the sacrifice of many in the front line we have not achieved our goals of providing safe, efficient, and cost‐effective care for all. Standards and benchmarks often lag or fail to be followed, best‐practices have been slow to spread, and quality differences have persisted among providers and geographic areas. These accounts, coupled with highly publicized medical malpractice litigation, have eroded patients’ trust in the healthcare system.

The current crisis isn’t new. It has evolved over the last 30 years to the current level of intensity that we now face and can no longer ignore. Reports including the Institute of Medicine’s “To Err Is Human” (Kohn 2000), “Crossing the Quality Chasm” (IOM 2001), and “Transforming Healthcare: A Safety Imperative” (Leape 2009) have highlighted the inability of the healthcare system to reliably provide safe, high quality, cost‐effective patient care. The crisis has deepened by rising expectations of patients who are accustomed to a retail setting, where services are customer‐driven, efficient, and accessible 24/7 through mobile connectivity, and are demanding the same from healthcare. A true “patient‐to‐consumer revolution” (Wyman 2014) is demanding increased access, service, personalization, and speed from a healthcare system that is slow, inconvenient, confusing and difficult to navigate. Competition among healthcare organizations is no longer based solely on reputation, but on service, value, and price.

In this environment, healthcare organizations face a significant pressure to provide high‐quality, state‐of‐the‐art patient care while lowering costs and improving patients’ care experiences. These demands exist in the context of heightened accreditation requirements, uncertain governmental mandates, decreasing reimbursement, and overwhelmed clinicians and administrators. The negative results are experienced by both patients and healthcare professionals.