I know of no more encouraging fact than the unquestionable ability of man to elevate his life by a conscious endeavor Henry David Thoreau - PowerPoint PPT Presentation

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I know of no more encouraging fact than the unquestionable ability of man to elevate his life by a conscious endeavor Henry David Thoreau

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I know of no more encouraging fact than the unquestionable ability of man to elevate his life by a conscious endeavor Henry David Thoreau – PowerPoint PPT presentation

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Title: I know of no more encouraging fact than the unquestionable ability of man to elevate his life by a conscious endeavor Henry David Thoreau


1
I know of no more encouraging fact than the
unquestionable ability of man to elevate his life
by a conscious endeavor
Henry David Thoreau
2
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5
Tension Between the Public and Health Care
Providers
  • Societys growing request for quality control
    and transparency within evidence-based healthcare
  • Conservative, authoritative, rigid, too often
    arrogant, expert-based medical professionalism

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Crossing the Quality Chasm. IOM, 2001
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In many hospitals in Israel (including Hadassah)
Local performance is almost never routinely
measured, because traditional medical training
assumes that doctors naturally aim for
excellence.
Only a few hospitals have successfully started
a systematic approach to quality improvement,
while others have failed trying outsourcing.
13
Plan of Action
  • Promote departmental initiatives of performance
    monitoring, using 1 or 2, self-chosen, indices of
    quality.
  • After individual meetings with 24 Department
    Heads, 14 have already defined tentative
    projects, such as outcomes of procedures, or
    patients understanding of informed consent.

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Plan of Action
  • Promote departmental initiatives of performance
    monitoring, using 1 or 2, self-chosen, indices of
    quality.
  • After individual meetings with 24 Department
    Heads, 14 have already defined tentative
    projects, such as outcomes of procedures, or
    patients understanding of informed consent.

17
Plan of Action
  • Promote departmental initiatives of performance
    monitoring, using 1 or 2, self-chosen, indices of
    quality.
  • After individual meetings with 24 Department
    Heads, 14 have already defined tentative
    projects, such as outcomes of procedures, or
    patients understanding of informed consent.
  • Collaboration with nursing staff medical
    school.

18
Plan of Action
  • Promote departmental initiatives of performance
    monitoring, using 1 or 2, self-chosen, indices of
    quality.
  • After individual meetings with 24 Department
    Heads, 14 have already defined tentative
    projects, such as outcomes of procedures, or
    patients understanding of informed consent.
  • Collaboration with nursing staff medical
    school.
  • Various educational activities.

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Justification for Cost (250,000/year)
  • Salaries for clinical leaders, data typist,
    coordinator, secretarial work.
  • Academic detailing costly but most effective to
    change physicians behavior.
  • Experience from industry outside medicine cost
    of quality/prevention far lower than cost of
    failures.
  • A safety culture requires willingness to direct
    resources.

23
Alternatives
Implement -ation Effectiveness Incremental Cost Criteria Options
poor poor Outsourcing
24
Alternatives
Implement -ation Effectiveness Incremental Cost Criteria Options
poor poor Outsourcing
? ? 0 Dept of Social Medicine
25
Alternatives
Implement -ation Effectiveness Incremental Cost Criteria Options
poor poor Outsourcing
? ? 0 Dept of Social Medicine
? ? 0 Clinical Dept Heads
26
Alternatives
Implement -ation Effectiveness Incremental Cost Criteria Options
poor poor Outsourcing
? ? 0 Dept of Social Medicine
? ? 0 Clinical Dept Heads
feasible possible Center for Evidence based Practice
27
Joint Commission on the Accreditation of
Healthcare Organizations - Revised Standards
Effective July 1, 2001
  • The leaders ensure implementation of an
    integrated patient safety program throughout the
    organization, including at least
  • Designation of one or more qualified individuals
    or an interdisciplinary group to manage the
    organization-wide patient safety program

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When God created the universe, it did not stand
up. God tried again and again but it kept
falling apart. Until God created the Tschuva
(Response/Responsibility).
Talmud (Rabbi Eliezers chapter III)
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