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To the class of 2005: Will you be ready for the quality revolution?
1Children's Hospital and Health Center of San Diego, USA. bsadler@chsd.org
Background:
Graduates are becoming aware of the vast changes occurring in the health care and scientific environments, which will place unprecedented demands on them.
A Second Revolution:
It has been suggested that the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm have alerted healthcare professionals and managers to system defects, enlisted a broad array of stakeholders in the agenda, and accelerated changes in practice needed to eliminate errors and unnecessary deaths. It is now commonplace for comparative data on the effectiveness of hospitals and medical groups to be published in this new age of transparency. Coalitions of employers are now urging the adoption of safer practices in hospitals. In addition, the science of quality improvement has flourished and become robust.
Coming Changes And Possibilities:
The changes over the next five years will be breathtaking. Those doctors and hospitals with the best clinical outcomes will benefit from seeing more patients and may even be paid more by Medicare, Medicaid, and insurance companies. Patients will access, via the Web, the latest quality information and make more informed choices about where to seek their care. The environment in which care is provided is also undergoing a major transformation. Hospital buildings themselves are becoming more healing, safer places. Graduates may ask themselves, "Will my residency adequately prepare me to understand and apply the science of quality improvement and evidence-based practice?"
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