October 29, 2007

Brought to you by Thomas Jefferson University’s Department of Health Policy

Volume II, Number 40

IHI Whole System Measures

This week the Institute for Healthcare Improvement released a white paper entitled Whole
System Measures as part of the Innovation Series. There is a great amount of variation in how
quality is measured throughout the health care system, so the IHI developed a system of measures
that promotes the use of a single system of metrics. The goal is to align the overall quality of a health
system to streamline improvement work across a hospital, group practice or health care system.
Whole system measures are a balanced set of system-level measures that supply health care
leaders and stakeholders with system-level data to allow evaluation of a health systems’
performance on core dimensions of quality and value. This data will, in turn, help quality
improvement specialists plan improvement initiatives. Whole System Measures are intended to be a
system-level measurement set -13 measures that are not specific to any disease or condition - which
compliments existing quality indicators. The intent is to provide an overview of performance at
different sites across a continuum of care. (IHI White Paper, 10/22,07)
Zagat Ratings for Health Care
Zagat is not only rating restaurants anymore. A report released this week indicates that
Wellpoint has partnered with Zagat surveys to create an online physician ratings compendium based
on patient feedback. More than 1 million Wellpoint members will have the ability to start using this
system in March of 2008, before it is available system wide. The rating system will be similar to the
format Zagat currently uses to rank restaurants, a 30-point scale ranking provider performance
based on trust, communication, availability and office environment. Patients will also have the ability
to place a comment on the site which will become visible when 10 comments for the same physician
are posted. This concept feeds directly into the current efforts to increase transparency in the health
care system and provides data in a format that will most likely be easily understood by most health
care consumers. (RWJF, 10/22/07)
Medical Errors the Result of Teamwork Failures
Physicians in training are particularly vulnerable to medical errors resulting from teamwork
failures according to a study published in Archives of Internal Medicine. Based on a review of 240
closed medical liability cases, the study found that errors in judgment, teamwork breakdowns, and
lack of technical competence were the most prevalent contributing factors. Failures of technical
competence were most often associated with decision-making and patient monitoring. Lack of
supervision and handoff problems were the most prevalent types of teamwork problems. The
authors suggest that graduate medical education reform should focus on strengthening these areas
of training. (AHA News Now, 10/23/07 and Arch Intern Med. 2007:167:2030-2036)
Psychosocial Needs of Cancer Patients
Attention to patients’ psychosocial health needs is the exception rather than the rule in
cancer care today. Many people living with cancer report dissatisfaction with the amount and type of
information they receive about their diagnosis and treatment options. To address and improve this
problem, the Institute of Medicine (IOM) studied the delivery of psychosocial services provided to
cancer patients and their families. Based on their review, the committee developed a standard to
guide for improvement of all cancer care. The IOM concludes that attending to psychosocial needs
should be an integral part of quality cancer care. The committee also recommends that
organizations, which set standards for cancer care, adopt the IOM standards, and incorporate
psychosocial health into their research and practice. (AHA News Now, 10/23/07 and IOM; Cancer
Care for the Whole Patient: Meeting Psychosocial Health Needs is available from the National
Academies Press, www.nap.edu )

Any questions regarding this newsletter can be directed

to Valerie Pracilio at valerie.pracilio@jefferson.edu or
Bettina Berman bettina.berman@jefferson.edu.