Is real-time quality assessment of health care an achievable goal?

Hospital-wide and real-time clinical outcome evaluation systems promote optimal quality of care with contained costs. These measurements of achieved health care benefits are critical for the ongoing process of national health care improvement. A practical hospital-wide quality improvement method, developed in the Veterans Administration Medical Center-Salt Lake City (VAMC-SLC), that evaluates positive, neutral, and negative outcome in relation to the mutual interactions between the health care provider, equipment, methodology, and patient is discussed. Real time or retrospective application of this analytical template to high risk procedures generates patient, practitioner, equipment, and methodology specific data to coordinate hospital-wide continuous quality improvement and cost containment efforts. It also allows system-wide comparative assessments of progress in the achievement of benefits within the national health care plan.