Have you ever checked Consumer Reports before purchasing a product? You wanted to check the quality and safety of the product and compare how one brand stacks up against another. Based on research conducted by the magazine, reviews by experts, comments from owners and side-by-side comparisons, you then made an educated choice about what brand met your needs. Sadly, there is no Consumer Reports in medicine where patients can compare the quality, safety and cost of healthcare procedures and treatments side by side.

Is there a "quality" problem in healthcare?
Across America, there are dangerous gaps between the healthcare people should receive and the care they actually receive. Compared to care in other countries, the U.S. is high-cost and low-quality—we spend more on healthcare, in total and per capita, than any other country in the world. Yet the U.S. ranks 10th in life expectancy among major industrialized nations and 27th in infant mortality. The United States’ overall ranking is 37th in the world, lower than any other developed country, according to the World Health Organization.

The visible problems with our healthcare system are the soaring costs and the number of uninsured Americans. The invisible problem is poor quality that comes in three forms—underuse, overuse and misuse.

Underuse. We do not give people the care they should get. We neglect to give them medically necessary care or follow proven healthcare practices.

Overuse. Americans get a lot of healthcare that we know doesn't help them. We often treat people without medical justification or fail to follow equally effective options that cost less or cause fewer side effects.

Misuse. Errors are made throughout the healthcare system. Between 44,000 and 98,000 people die annually from preventable errors—more than from motorcycle accidents, breast cancer or AIDS. Some errors are human, but systems within hospitals, doctor's offices and elsewhere can be designed to greatly reduce the risk of error and harm.

What does "quality care" look like?
Quality care is care tailored for patients that works and that is safe. The Agency for Healthcare Research and Quality defines quality care as "doing the right thing for the right patient, at the right time, in the right way to achieve the best possible results." This is what we all want for ourselves and our families.

Quality healthcare is:

• Safe. It doesn’t injure patients it is supposed to help.
• Effective. It is based on sound science for all who can benefit and refrains from providing services to those who cannot. 
• Patient-centered. It is respectful of and responsive to patient’s preferences, needs and values. 
• Timely. It reduces waiting time and potentially harmful delays. 
• Efficient. It does not waste resources. 
• Equitable. It does not vary because of someone’s race, gender, income or location.

(Crossing the Quality Chasm: A New Health System for the 21st Century)

For patients, quality care is care that works—based on the best medical research about what has made you ill and what will make you better. It is getting care when you need it. It is getting all the care you need, and not getting care that doesn’t help you. It is safe—it only helps and doesn’t harm you. It is tailored to you. And it is delivered by professionals who respect you, communicate clearly with you, and involve you in decisions about your care.

Quality: It’s in our name
Quality Quest for Health of Illinois is building a statewide collaborative of physicians, hospitals, health plans, employers and consumers in order to improve the quality and value of care provided to patients. Our quality improvement teams (Quest Teams) use 6 Sigma methodology to get at the heart of an issue and define real solutions. Our 2008 teams focused on preventive care, healthy lifestyles, reducing heart attacks and strokes, medical home pilot, and adopting best practice guidelines from the Institute for Clinical Systems Improvement.
To learn more about Quality Quest for Health of Illinois and our quality improvement projects, visit qualityquest.org. iBi

2009 QUALITY QUEST TEAMS

Patient Registry Team

TEAM LEAD: Jean Kestner, Methodist Medical Center of Illinois
BLACK BELT: Cheryl Toland, Quality Quest for Health of Illinois

What is a registry? Patient registries help practices identify whole populations of patients, for example, all patients with diabetes or hypertension, all men over age 50, or all children under age two. Registries assist physicians and their staff with managing patients in a proactive and organized manner.

Three Quest Teams—Preventive Care, Reducing Risk of Heart Attacks and Strokes, and Implementation of ICSI Guidelines—worked diligently in 2008 and thoughtfully analyzed their topics, and all arrived at a similar conclusion. Practices in our region need registries in order to make real and lasting improvements in care.

Medical practices that do the best job of helping patients stay healthy use their registry to identify missed services or treatment goals that aren't being met. They measure their success and make changes to clinic processes to get better results. Electronic health records help, but are not essential to implementing a registry. The Quest Registry Team will be looking at ways to help physician practices develop patient registries.

High Technology Imaging Team

TEAM LEAD: Carter Young, M.D., Central Illinois Radiological Associates
BLACK BELTS: Anoop Mahajan, CGN; Cheryl Toland, Quality Quest

In the last 10 years, the number of CT scans and MRI scans per patient has doubled and tripled, respectively, according to a 2008 Health Affairs article. Experts raise concerns about the safety and efficacy of this type of increase. Rapid increases in high technology imaging have also contributed to rapidly escalating healthcare costs. The urgency of addressing this issue is the increased risk of harm to patients from radiation. The FDA estimates that an adult's lifetime risk of developing radiation-induced cancer from a CT scan is roughly one in every 3,000 scans performed.

The Quest High Technology Imaging Team will use guidelines from the American College of Radiologists to help physicians know when to order imaging tests. Success will mean safer, less expensive healthcare.