Quality insights: Clinical quality in primary care (available at www.mhqp.org ) 23 Kowalczyk Bay State doctors rated among best; Web list shows areas where care excels – and lags
- 22 Massachusetts Health Quality Partners
" The knowledgeable health reporter for the Boston Globe, Betsy Lehman, died from an overdose during chemotherapy. " So begins the Executive Summary of a 1999 Institute of Medicine Report, " To Err is Human " that raised the problem of medical errors onto the national consciousness. The IOM report catalyzed a flurry of activity among health care providers, government agencies, and non-profit coalitions to measure health care quality more effectively and to implement system changes intended to reduce medical errors and improve patient outcomes. While considerable work has been done over the past six years, there remains significant room to improve the quality and safety of health care in the Commonwealth. The state's hospitals and health plans have scored favorably on national surveys such as those published by U.S. News and World Report. 1 Massachusetts hospitals and physicians do relatively well on measures now being reported by the Centers for Medicare and Medicaid and the National Committee for Quality Assurance (NCQA). Yet a recent study by the Rand Corporation concluded that U.S. adults receive only 55 percent of recommended care, with few differences found between Boston and eleven other metropolitan areas. 2 Other research shows considerable variation in hospitalizations , treatment and costs across regions and between hospitals in the same geographic area. 3 This issue brief provides some background on the definition of quality health care, provides data on how Massachusetts is performing, and summarizes what is currently being done to improve the quality of care. Finally, a brief description of two models of quality improvement that have received national attention, the Pittsburgh Regional Healthcare Initiative and the Veterans Health Administration (VHA), are provided.