Partnering for better care
NOW THAT Massachusetts has made significant progress toward guaranteed access to healthcare, the Commonwealth must turn to a new challenge: ensuring that the medical care provided is of the highest possible quality.
We start, of course, from a position of strength: excellent physicians, hospitals, and other health professionals committed to delivering the best possible care. But some of the most important voices in the conversation have not yet been fully heard. They are patients and their caregivers, and they, as much as providers and institutions, must be fully engaged in improving the quality of care.
Ensuring that they do requires a broad-based, collaborative effort to educate patients about the positive difference they can make. That's the idea behind the Partnership for Healthcare Excellence, a new, nonprofit coalition.
Comprised of more than 40 organizations - including the Massachusetts Health Care Quality and Cost Council, consumer associations, disease and advocacy organizations, doctors, nurses, hospitals, community health centers, insurers, business groups, labor, public health advocates, and other healthcare leaders - the partnership was formed to attain three goals: educating people about variations in the quality of healthcare; encouraging patients to become more informed and involved in their own care; and mobilizing consumers to become advocates for the kind of overall change necessary to improve the quality of healthcare.
The challenge before us is considerable, and the stakes are high. A study by the RAND Corporation found that Americans with common health problems receive only about 50 percent of "recommended care." The Institute of Medicine has reported that "serious and widespread quality problems exist throughout American medicine." According to the same group, some 1.5 million Americans are injured by medication errors every year. Meanwhile, a survey conducted by the partnership showed that nearly one in five adults in Massachusetts has experienced a medical error, while 52 percent know someone who has.
One of the strongest barriers against medical errors - and among the most powerful resources for improving the quality of healthcare - is an informed, empowered, and engaged patient.
Patients who see themselves as partners in their own care choose doctors and hospitals based in part on the quality of care they provide. They ask more questions about their conditions and speak up more forthrightly about their symptoms. Because they understand treatment regimens more fully, they are able to follow them more closely.
Evidence indicates that patients are eager to become more involved partners in their care. What many feel they lack is information that will empower them to do so. That's why the partnership was formed.
The partnership is working to make a broad array of information available to patients and caregivers, such as how to take medications safely, the kinds of factors to consider when choosing a doctor or hospital, and how to prepare for doctor or hospital visits. Information will be added based on input from consumers and member organizations.
Most important, we hope to empower patients to speak up in healthcare settings - whether it's explaining all of one's symptoms to a physician or asking hospital employees with whom a patient comes into contact whether they have washed their hands.
That simple step - speaking up in medical settings - can save lives and improve the quality of healthcare. Yet speaking up is something many patients and caregivers are understandably reluctant to do. Some are concerned that healthcare providers will see them as pests. But physicians know the care they provide is only as good as the information they receive - which is one reason skilled doctors are skilled listeners, too.
Most of all, patients should actively engage in decisions about their care because it's their health at stake. They have every right to act and be treated as what they are: partners in their own health. Indeed, if health reform is to succeed - and if Massachusetts' healthcare system is to operate at the level to which it aspires - that right comes with a responsibility: speaking up - and speaking out. That's a power within every patient's hands.
Jim Conway is chairman of The Partnership for Healthcare Excellence and senior vice president of the Institute for Healthcare Improvement.
