Initiative to Improve Health Care
Seeks Wider Adoption of Quality Innovations

Two leading health care groups announced today the launch of a national initiative to identify and spread the word on innovations in health care delivery and medical practice.

The initiative, Accelerating Change Today (A.C.T.) ñ For Americaís Health, aims to improve the quality of health care in the United States by:

• Building public awareness of the need for quality improvements
• Identifying innovations and “best practices” in medicine that are yielding better patient care; increasing access to timely medical care; lowering medical costs; making the health system easier to use; and reducing errors and inappropriate care
• Accelerating the spread of best practices throughout the health system
• Changing the culture of medicine to nurture acceptance of best practices and scientifically-based (or “evidence-based”) care

The initiative will comb the nation for exemplary medical practices. It will select those whose adoption (by hospitals, doctors, nurses, and managed care plans) in other communities, and perhaps nationally, would improve the quality of health care and achieve better patient outcomes. The selected “best practices” will be profiled in periodic non-technical reports, the first two of which will be published in 1999. The reports will be widely disseminated to hospitals, doctorsí and nursesí groups, managed care plans, health insurers, the media, key business and consumer groups, employer health care coalitions, and federal and state government health agencies. A.C.T. ñ For Americaís Health is a collaborative effort of the Institute for Healthcare Improvement (IHI) and the National Coalition on Health Care (NCHC). IHI specializes in identifying innovations in health care and disseminating that information to health professionals. NCHC has the capability of reaching a broad audience outside the medical community. IHI is an independent, non-profit organization based in Boston and founded in 1991. Its founder and president, Donald Berwick, M.D., is one of the nationís leading authorities on health care quality. The NCHC is a non-profit and non-partisan education and information group based in Washington, D.C. Its nearly 90 member organizations include a diverse array of health care stakeholders. They include individual businesses, unions, leading consumer and doctorsí groups, academic health centers, and religious organizations. The Coalition believes that improving the quality and efficiency of health care is the most significant means to achieve lasting control over the rising cost of health care. “We are very excited about this new venture,” said Henry E. Simmons, M.D., M.P.H., president of the Coalition. “Improving the quality of health care in this country must become a national priority for the 21st century. With this initiative, we hope to do our part to move towards the goal of a system that is as nearly free of errors and inappropriate and unnecessary care as is humanly possible.” A report by Dr. Berwick, As Good as it Should Get: Making Health Care Better in the New Millennium, is being released today by the Coalition. It cites numerous examples where clinicians and health care administrators have either reduced inappropriate care or improved care ñ and saved money in the process. For example, at Pheobe Putney Memorial Hospital in Albany, Georgia, doctors and administrators became convinced that patients in intensive care units (ICU) were being unnecessarily sedated with overly potent and expensive drugs. They reduced dosages and started using less expensive medicine. Patients were better off and the cost of an average day in the ICU fell 20% over three months. Likewise, many hospitals and surgeons are trying to reduce the cost and improve the success of heart surgery. At Rochester General Hospital in Rochester, N.Y., surgeons cut operating time and improved patient outcomes after they developed a “continuous flow” process which more efficiently used doctorsí and nursesí time. After the changes, patients were re-hospitalized half as often. Similarly, the report says doctors at Loma Linda University Medical Center in Loma Linda, Calif. enhanced the efficiency of bypass surgery and reduced its average cost to $8,000. The national average in $18,000. “Every hospital and medical center in the nation can undertake this kind of improvement,” said Dr. Berwick. “The amazing and simple message we have is that making these changes will, almost always, not only make patients better, faster but also save money and lower the cost of health care.” But the report says the quality improvements and innovations achieved by hospitals and doctors on a local level have not yet caught fire nationwide. What Toyota and other Japanese auto makers did for their industry, Berwick says, must now occur in health care ñ “a breakthrough example of system-level performance of unprecedented quality at affordable cost.” The report also concludes: “Recent attention to creating a patient ëbill of rightsí is welcome, and badly needed as a form of reassurance to a worried American public. But a patient bill of rights is not nearly enough to address the overall need for improvement of health care nationwide. That need is broad, deep, and pervasive ñ far beyond mere protection of rights.”