The Effectiveness of Quality Improvements

Michelle Moore

Professor Clark

APSU 355

December 15, 2013

The Effectiveness of Quality Improvements

Michelle Moore

Professor Clark

APSU 355

December 15, 2013

The Effectiveness of Quality Improvements

“Seasoned clinical ethicists have a saying: You cannot bite a wall. The saying refers to that demoralizing moment of taking in the scale of a really big challenge in health care” (Berlinger 30). We have two options when we find ourselves up against this wall. One is to ignore it. This means ignoring the needs of the patients that could be harmed by care that is not as good as it could be. The second is to be ethical. We find a crack in the wall and work away at it. The trick is to avoid the temptation to bite off just a bit and declare victory, rather than staying connected to others working on the whole wall. Quality improvement in health care can look like yet another unbitable wall.

The quality of medical care is a main concern for health care proffessionals, and along with the concern for medical care, there is also the concern for making improvements as well as managing those improvements.

The management of health care quality is not a new enterprise. It can be traced to the Flexner Report (1910) that advocated more rigorous requirements for professional medical education and resulted in the closing of about one-third of the medical schools. More recently, the debate on health care quality has been influenced by Avedis Donabedian’s (1969) writings which view quality of medical care in terms of structure, process, and outcome (Larson & Muller 261).

The framework developed by the Institute of Medicine in several influential reports defines quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (“The Place of Quality Improvement” S7). “Quality improvement means any process or tool aimed at reducing...