Why Quality ?
“Quality is doing the right thing…but only the right thing…at the right time…for every patient.”
- Michael Fleming, MD President, LHCQF
The health status of the population in Louisiana consistently ranks low when compared to other states, even though our spending per person on health care ranks high. In the 2007 Commonwealth Fund State Scorecard on Health System Performance, Louisiana was one of the lowest-performing states and received rankings of 33rd in access, 41st in quality, 51st in avoidable hospital use and costs, 28th in equity, and 50th in healthy lives. Louisiana’s rates of obesity and premature death are higher than average, as are our rates of avoidable hospital admissions, emergency room visits and drugs prescribed.
In addition to wide variation between states, there are also wide variations within states. Dr. David Wennberg with Health Dialog found in his report titled, Health System Improvement Opportunities in Louisiana: Analysis Through the Lens of Unwarranted Variation:
Large variations in the quality, cost, and utilization of care across regions within Louisiana cannot be fully explained by health status, insurance type, race/ethnicity or gender of the population. Higher insurance-based expenditures did not lead to better quality. The uninsured appear to use emergency rooms for chronic disease in lieu of other sources of care, suggesting a lack of access to primary care.
The report states that variations are likely attributable to structural characteristics of the State’s public and private delivery systems and the practice patterns and behaviors of providers within these systems.
The Quality Forum has embraced the perspective adopted by the Institute of Medicine, among other organizations, that poor outcomes are not the result of “bad people doing bad things.” Instead, as the Institute of Medicine has said, they are “…the result of good people working in bad systems.”
The Forum is committed to involving and organizing committed individuals, soliciting a host of perspectives, analyzing and interpreting the data; and then working to move our organizations toward a consensus of what are the ‘right things’ to do to improve health outcomes in Louisiana.
9/19/08