Patient Safety/Quality of Care

Physicians' involvement in patient safety and quality of care may be pivotal to maintaining medicine's credibility

The involvement of physicians in efforts to improve patient safety and care quality is essential to assure success and to maintain medicine's credibility, according to participants at the September 2001 conference, "The Role and Responsibility of Physicians to Improve Patient Safety." Unfortunately, many doctors have not yet embraced quality improvement efforts. Furthermore, some physicians resist being measured and may hide problems out of fear of litigation, explains Carolyn M. Clancy, M.D., Director of the Agency for Healthcare Research and Quality, in a recent article.

Dr. Clancy and her colleagues—including the late John M. Eisenberg, M.D., the former director of AHRQ—cite several opportunities to encourage doctors to take a leadership role in quality improvement and patient safety. These opportunities were identified during discussions at the conference, which was sponsored by AHRQ and the ABIM Foundation. Conference participants included a broad array of stakeholders in health care delivery. Examples identified during the conference include:

• Integrate assessments of doctors clinical performance into the board certification and credentialing process.
• Identify which incentives would encourage doctors to improve patient safety.
• Identify safety standards in office settings, not just hospitals.
• Develop the business case for identifying which interventions in outpatient care are most effective and for which patients in order to make practical improvements in office-based practice.
• Identify and train physician leaders to influence best practices among other doctors.
• Involve local groups in measuring, monitoring, and improving quality by engaging the existing grassroots infrastructure.
• Develop a common language and measures for safety.
• Create safety-related awards for individuals, groups, and societies.
• Put patient safety information in the public domain without compromising privacy or promoting litigation.

The authors note that even modest change can lead to substantial improvement. They conclude, however, that much greater input is needed from medical societies and professional standard-setting bodies.

More details are in "When is 'good enough'? The role and responsibility of physicians to improve patient safety," by Leslie D. Goode, M.H.S., Dr. Clancy, Harry R. Kimball, M.D., and others, in the October 2002 Academic Medicine 77(10), pp. 947-952.

Reprints (AHRQ Publication No. 03-R005) are available from the AHRQ Publications Clearinghouse and AHRQ InstantFax.

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