Friday, May 18, 2012

Economics of improving quality

There is a constant tension in healthcare between the economic/ financial imperatives and the clinical demands. Not unreasonably, based on healthcare inflation around the world over the last 40 years, there is a belief that more (which for many people, clinicians and patients) healthcare is better healthcare. Those of us interested in quality believe that this is not always the case. However the quality people I believe have been remiss in not addressing the evidence base for what they do, or the economic benefits of improving quality. Followers of Deming believe unequivocally that improving quality drives down cost. Brent James firmly believes that improving quality in Intermountain has not only improved care but dramatically driven down costs. Hence the importance of this paper just published and free to access.

The authors aim was to systematically review comparative economic analyses of patient safety improvements in the acute care setting and they explored 15 patient safety conditions and six associated improvement strategies. They concluded that pharmacist-led medication reconciliation, the Keystone ICU intervention for central line-associated bloodstream infections, chlorhexidine for vascular catheter site care, and standard surgical sponge counts were economically attractive strategies for improving patient safety.

Great stuff, a lot more needed.

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