MMA Viewpoint
The Pursuit of Excellence
The pursuit of excellence, one of the pathways to high-quality care identified by our MMA Quality Committee, calls for us to improve quality in both the science and art of medicine. This includes a variety of initiatives—using evidence-based guidelines, measuring quality, and finding better ways to motivate our patients to follow our medical advice.
We all understand the importance of evidence-based medicine—seeking out and understanding the recent science, evaluating new guidelines, and figuring out ways to implement the latest constructs in health care. We are fortunate in Minnesota to have the Institute for Clinical Systems Improvement, which is recognized throughout the world for its stellar work in guideline development.
Although most of us agree that we must try to follow evidence-based guidelines, not everyone believes that we must measure ourselves to ensure that they are implemented. In quality-improvement circles, however, the mantra is “That which gets measured gets done.” None of us likes to be measured, but it is becoming the standard in all of the service industries. A couple of years ago, I spoke with a financial consultant who showed me his stock portfolio results for the past years, his client satisfaction rates, and how his record compared with some industry benchmarks. He had clear ways to demonstrate quality. In medicine, we are still in the infancy of measuring quality. This past year, the MMA became involved in the Community Measurement Project (www.mnhealthcare.org), which compares practices throughout the state. The goal is to find measures that are meaningful, relevant to medical practice, and statistically significant. If we achieve this, I believe that measurement can positively influence our delivery of health care. Poor, irrelevant data, however, will turn physicians and others in the health care delivery system against measurement. Working with all the interested parties is a real challenge.
We pursue excellence not only through the “hard” science of evidence-based medicine but also through the art of medicine. I believe that in the near future, more lives will be saved because we learned how to motivate our patients to follow our advice than because of new technological breakthroughs. Research is showing us more effective ways to counsel our patients. Did you know that if a telemarketer asks “How are you today?” before beginning a sales pitch, you are twice as likely to stay on the line? If we have our nurse or care coordinator contact our patients one week after their clinic visit, our patients are much more likely to follow our medical advice. Unfortunately, most of us do not have financial backing to do this in house. If it is done, it is by third-party care managers calling from another part of the country.
Resources are available to help us improve communication with our patients. For instance, the Kaiser Permanent Health System has developed information on better patient interviewing during a clinic visit. In a future issue of Minnesota Medicine, look for ideas on how to get all the information you need in less time and how to motivate patients to follow medical advice.
The atmosphere of our workplace can also affect quality of care. Our attitude significantly affects how well our patients comprehend and follow our advice. Patients also sense and respond to the environment of our clinics and hospitals. We must strive to create safe workplaces in which all workers respect each other as well as the patients.
Pursuing excellence in medicine challenges us to improve all aspects of the care we provide.