Determining whether healthcare quality has improved over time requires a robust measure of rates of harm, according to a commentary in the American Journal of Medical Quality.
Peter J. Pronovost, MD, PhD, senior vice president for patient safety and quality and director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine in Baltimore, and Robert M. Wachter, MD, chief of medical service and hospital medicine at UCSF Medical Center in San Francisco, examine how healthcare quality and safety have changed over the years.
While some studies using the Global Trigger Tool measure of safety have shown high rates of patient harm remain, other studies, such as the Agency for Healthcare Research and Quality's report on its bloodstream infection initiative, have shown improvement.
The authors state that it is difficult to conclude whether American healthcare has improved quality and safety because the industry lacks a robust measurement of adverse event rates, as opposed to measures of adverse events at single points of time. "Sadly, when it comes to our national effort to improve patient safety, we do not know today whether the glass is half empty or half full," they wrote. "Finding efficient and robust ways to determine whether medical care is safer should be a national priority."
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