Jan 15, 2008

Improving quality and safety of hospital care: a reappraisal and an agenda for clinically relevant reform

Internal Medicine Journal
I A ScottS Jayathissa

Abstract

Improving quality and safety of hospital care is now firmly on the health-care agenda. Various agencies within different levels of government are pursuing initiatives targeting hospitals and health professionals that aim to identify, quantify and lessen medical error and suboptimal care. Although not denying the value of such 'top-down' initiatives, more attention may be needed towards 'bottom-up' reform led by practising physicians. This article discusses factors integral to delivery of safe, high-quality care grouped under six themes: clinical workforce, teamwork, patient participation in care decisions, indications for health-care interventions, clinical governance and information systems. Following this discussion, a 20-point action plan is proposed as an agenda for future reform capable of being led by physicians, together with some cautionary notes about relying too heavily on information technology, use of non-clinical quality personnel and quantitative evaluative approaches as primary strategies in improving quality.

  • References67
  • Citations7

References

Mentioned in this Paper

communication and information technology
Hospital Organization and Administration
Health Care Reform
LINC00273 gene
Physicians, Junior
Physician's Role
THOP1 gene
Patient Participation
Information Systems
Clinical Audit

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