Get Ready for Quality Improvement: Panelists outline helpful metrics and more

by Mary Beth Nierengarten •

Key Papers on Quality Improvement

  • Schwappach DLB. Engaging patients as vigilant partners in safety: a systematic review. Med Care Res Rev. 2010;67:119-148.
  • Weber RS, Lewis CM, Eastman SD, et al. Quality and performance indicators in an academic department of head and neck surgery. Arch Otolaryngol Head Neck Surg. 2010;136(12):1212-1218.
  • Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. JAMA. 2010;304(15):1693-1700.
  • deVries EN, Eikens-Jansen MP, Hammersma AM, et al. Prevention of surgical malpractice claims by use of a surgical safety checklist. Ann Surg. 2011;253(3):624-628.
  • Bishop TF, Ryan AM, Casalino LP. Paid malpractice claims for adverse events in inpatient and outpatient settings. JAMA. 2011;305(23):2427-2431.

Patient Involvement

Matthew A. Kienstra, MD, section head of ENT and oral surgery and director of the Facial Trauma Services at St. John’s Mercy Medical Center and Clinics in Springfield, Mo., focused attention on an issue raised in a study (Medical Care Res Rev. 2010;67:119-148) that looked at what he thinks will be a growing trend: the involvement of patients in their own safety. An example of this, he said, is “Speak Up,” a program sponsored by the Joint Commission that has focused on hand washing to decrease infections. Other examples are exercise and safe sex programs and breast self-exams.

Dr. Kienstra noted several risks that come with basing quality improvement on involving patients in their own care, including the patients’ perception that they bear the burden of their illness, a misconception that may lead to an erosion of trust between physician and patient and potential punitive consequences in terms of reimbursement for perceived insufficient involvement.

Overall, he said that engaging patients in their own safety has not been shown to be effective and has been poorly studied. The key for patient involvement is staff involvement, he added. The idea of including patients in their own safety is not perfect, he said, “but can be successful over time and needs to be done down the road.” ENT Today

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