The Department of Anesthesiology and Perioperative Medicine has created a new Section on Quality and Patient Safety effective September 1, 2007. Quality healthcare delivery is the new focus in many areas in the United States healthcare system. Since healthcare costs are rising at a pace much greater than inflation or the consumer price index, corporations providing health benefit plans want assurance that the cost of these benefits are linked to a high quality product.
While large corporations have started quality and value analysis through groups such as Leapfrog and the Institute for Healthcare Improvement, the government is now on board with the concept. The Tax Relief and Healthcare Act of 2006 specifically requires Pay for Performance measures to be implemented over time for both hospitals and physicians. Hospitals began reporting process outcomes data to Medicare about three years ago on certain core measures of performance on a voluntary basis. Physician voluntary reporting began July 1, 2007. For anesthesiology, antibiotic administration within one hour of surgical incision is the only current measure to report. By participating, physicians will receive a "bonus" of 1.5% of total Medicare billings for the reporting period. Many believe that it is only a matter of time before quality data is used in a scaled performance based payment system. Concepts such as "value-based competition" will likely dominate health care finance in the future.
Our major residency accrediting body, the ACGME, now requires programs to teach residents "systems-based practice" and how to evaluate practice outcomes. We will be judged in the future on the outcomes of our resident performance.
In order to address these important issues, the Department created the section on quality to help monitor our clinical and business performance, institute appropriate changes in our practice based upon evidence-based guidelines and practice advisories, educate our faculty and residents on this new quality paradigm, and help to lead the nation in this initiative. There are a few departments in the country that have devoted appropriate resources to such an endeavor. The section will utilize our Quality Improvement, Education, and Clinical Practice Committees, as well as our Department's financial staff, to work together to improve quality measures. A full-time data manager will assist with data collection, mining and analysis, and web-based in-service education. The department's financial staff will assist in fiscal analysis and provide fiduciary direction. This effort is lead by Drs. Art Boudreaux, Robin Walters, Susan Black, Jim Hunter, Teresa Mahaffey, Dawn Bulgarella and Kamara Savage. Many others will contribute to the effort to improve our practice. We are indebted to Tony Jones, M.D., for his insight in providing the support necessary to make this effort possible.