Quality Initiatives Earn Low Marks


More than 70% of people who responded to a survey at had a negative opinion about how local and national quality initiatives (QI) have impacted their ability to care for hospitalized patients.

Survey respondents were asked to gauge the effectiveness of core measures, Physician Quality Reporting System (PQRS) reporting, and clinical reminders. A combined 38% of respondents said that QI measures produced little benefit for their patients or rarely addressed patients' acute issues. Another 21% of respondents labeled QI measures as "distractions," and 12% said QI measures affected their productivity.

Only 28% of respondents thought that QI have improved inpatient care, just 2% more than those who found "little benefit" to them (26%), indicating that 54% of respondents were nearly evenly split on whether QI measures directly benefit patients.

Felix Aguirre, MD, FHM, vice president of medical affairs for IPC: The Hospitalist Company and a member of SHM's Performance Measurement and Reporting Committee (PMRC), says while certain core measures, such as PQRS reporting, may not address the specific needs of all hospital patients, it does not make them unsuccessful.

"I think measures do improve care, even if it's not for my patients, [then] for the global population of patients," Dr. Aguirre says. "We're not moving the needle quickly by treating my patients; we're moving the needle slowly, but surely, by treating all patients."

PMRC chair Gregory B. Seymann, MD, SFHM, clinical professor and chief of the division of hospital medicine at University of California San Diego Health Sciences, says the variety of QI measures included in the survey may explain the difference in opinions.

"There are multiple different practice arrangements among the general population of hospitalists and thus many different ways an individual respondent might interact with the measures," Dr. Seymann says. TH

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