Article Review

HW. No. 3
Article:
Keeping Patients Safe: The Ethics of Quality Improvement
Sara Platte, MD

https://journalofethics.ama-assn.org/article/keeping-patients-safe-ethics-quality-
improvement/2008-05
Review:
The above mentioned article discusses the ethical issues related to Quality Improvement programs
in health care industry. The article provides that advent of quality improvement programs as a
data driven method and a scientific approach for enhancing the quality of patient care and
improving the health care standard has brought up the ethical issues related to it as most of these
quality improvement programs involve some change in established patient treatment and
medication process.

The dilemma demanded the clear definition of health care quality improvement which was
provided by ‘Hasting Centre’. It defined the quality improvement as a systematic data driven
approach to bring improvement. The second issue involved holding quality improvement projects
in health care to normal Human Research standards as they also involved experimentation on
humans. The members of ‘Hasting’ maintained that the core aim of quality improvement in health
care is to increase effectiveness of patient care and treatment so they shall not be held to same
methods of Institutional Review Boards (IRB) for human research. The team also provided
guidelines for addressing the issue by internal management of Quality Improvement Projects,
clearly defining the objectives, publishing the results and expanding accreditation bodies’ scope to
ensure sanctity of internal quality improvement programs.

The article also discussed a controversy regarding the use of checklist for decreasing hospital
acquired infections as the checklist was not subjected to IRB. The investigation by responsible
department maintained that the issue was not in violation of y law as the use of checklist was
linked to the improvement in health care services provision. In short aim of Quality Improvement
projects is to improve health care provision.

In my opinion I would also have sided with the findings of ‘Hastings’ group and maintained that
there is no need to implement IRB practices for quality improvement projects.