SUMMARY
The opportunity to improve patient care is significant, and the
pressure to improve the quality of perioperative care will continue to increase.
Traditional approaches to quality improvement have produced disappointing results,
or their impact on patient outcome has not been adequately evaluated. If we want
to improve the quality of care that we provide, we must be able to measure performance.
Nevertheless, significant barriers to measuring quality exist, including a lack
of information systems and a lack of agreement on how to measure quality of care.
Anesthesiologists and professional societies may need to partner with experts in
quality measurement to develop and implement quality measures. In choosing what
we should measure, several criteria must be considered, and measures should provide
insights into multiple domains of quality, probably a combination of structure, process,
and outcome measures.
Future efforts should balance the feasibility and validity of
quality measures and develop integrated approaches to improving quality, including
strategies to develop care bundles, decrease complexity, and create independent redundancies.
We also need to ensure providers have the skills necessary to improve quality.
We will cross the quality chasm only when all workers view quality and safety as
primarily what they do rather than as an added activity.
