Faculty Responsibility for Clinical i l Quality Karen Kmetik, PhD September 19, 2008 Objectives The Academic Mission: Key Roles for Academic Faculty R

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1 Faculty Responsibility for Clinical i l Quality Karen Kmetik, PhD September 19, 2008 Objectives The Academic Mission: Key Roles for Academic Faculty Research Education Outstanding t Clinical i l Care

2 If we knew what it was we were doing, it would not be called research, would it? Albert Einstein The Role of Academic Centers: Research Defining the evidence based through translational research Contributing to the design of the next generation of performance measures Testing the feasibility of performance measures and dth their impact Testing the implementation of measurement within the fabric of care Evaluating the value of performance measurement to improve the quality of care

3 The Research Agenda Defining the evidence base through translational research Contributing ti to the design of the next generation of performance measures Testing the feasibility of performance measures and their impact Evaluating the value of performance measurement to improve the quality of care Teaching is more difficult than learning because what teaching calls for is this: to let learn. The real teacher, in fact, lets nothing else be learned than learning. His conduct, therefore, often produces the impression that we properly learn nothing from him, if by "learning" " we now suddenly understand merely the procurement of useful information. Martin Heidegger

4 The Role of Academicians: Teacher Role Model The Unwritten Curriculum A passion for quality Engendering intellectual curiosity Professionalism Training the next generation of quality champions Practical Considerations We are all failures - at least, all the best of us are. J.M. Berrie, English playwright

5 The Role of Academicians: Outstanding Clinical Quality Incorporating Quality Improvement into Practice Focusing on quality not just at the patient t level but at the system level Encouraging recognition of gaps in quality and responsibility for measurement Implementing Quality Measurement Research The Opportunities: Organized Medicine Ask the right questions Guideline development Impact of quality measurement Teaching Focus on high quality, cost effective care Incorporate QI in curriculm Encourage next generation of physicians Provide opportunities for faculty development Clinical Care Commit to measuring quality Monitor outcomes

6 The AMA Convened: Physician Consortium for Performance Improvement (PCPI) PCPI Mission Improve patient health and safety by: Identifying and developing evidence-based clinical performance measures Promoting the implementation of clinical performance improvement activities Advancing the science of clinical performance measurement and improvement

7 The Commitment: Measures that Matter Measures that are linked to desired clinical outcomes for our patients Measures that t support physicians i in providing high quality, efficient care Measures that are incorporated into efforts to improve the health care delivery system Descriptions and specifications for PCPI performance measures are available for 31 clinical topics or conditions Acute otitis externa / otitis media with effusion Adult diabetes Anesthesiology and critical care Asthma Chronic kidney disease Chronic obstructive pulmonary disease Chronic stable coronary artery disease Community-acquired bacterial pneumonia Emergency medicine End stage renal disease Eye care Gastroesophageal reflux disease Geriatrics Heart failure HematologyHepatitis C Hypertension Major depressive disorder Melanoma Osteoarthritis Osteoporosis Outpatient parenteral antimicrobial therapy Pathology Pediatric acute gastroenteritis Perioperative care Prenatal testing Preventive care and screening Adult influenza immunization * Colorectal cancer screening * Problem drinking * Screening mammography * Tobacco use * * Asterisk indicates performance measures included in the preventive care and screening measures collection. Prostate t cancer Radiology Stroke and stroke rehabilitation

8 PCPI 2008 Strategic Priorities New measure development: Care coordination, patient safety Appropriateness p (overuse) Clinical areas with clear gaps, unexplained variation New measure analyses: Potential cost savings from measures of overuse New levels of measurement: Episode of care; physician, team, care setting Foster quality improvement registries Leading the Search for Solutions: The Physician Consortium for Performance Improvement (PCPI i Karen.kmetik@ama-assn.orgassn.org