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A Subject You Can't Ignore

Maureen Larkin, Senior Editor, Quality, January 10, 2008

If you've been in healthcare for any length of time, you've no doubt heard the name Ernest Amory Codman. Namesake of The Joint Commission's annual award for performance measurement, the Harvard-trained surgeon may have been the industry's first quality guru.

Frustrated by the lack of attention his fellow surgeons paid to patients after they left the hospital, Codman strongly believed that it was up to physicians to ensure that the work they did for patients was not only high quality, but continued to serve them in the months and years that followed. His "End Results System" encouraged physicians to collect data from their patients for at least a year after treatment. Eventually, the surgeon started his own Boston Hospital--called the End Results Hospital--and published the hospital's quality data in his 1918 book, A Study in Hospital Efficiency: The first five years.

Codman's ideas were strongly resisted by his fellow physicians, and his philosophy eventually ended his career. Colleagues stopped referring their patients to him, and not long after, his membership to the Massachusetts Medical Society was terminated. In the early 1900s, healthcare just wasn't ready for this quality advocate.

Today, not paying attention to quality is the career ending move. CEOs are constantly looking to not only generate revenue and promote financial growth, but also provide quality care to every patient. They're more involved than ever in making sure the patient has a positive experience at their facility. In last year's HealthLeaders Media Annual CEO survey, 53 percent reported their performance bonuses are based at least partially on quality and patient safety.

CEOs aren't the only ones paying attention to quality. HealthGrades, Thompson, U.S. News & World Report and others are keeping quality scores in the public eye and many states are jumping on the bandwagon, requiring the publication of death rates, giving of aspirin to cardiac patients, and other measures. In March, the first scores from the federal government's Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) will be released, and hospitals are bracing for the media's reaction.

Quality is indeed the most talked about topic in healthcare and that's why I'm proud to introduce HealthLeaders Media's new e-newsletter QualityLeaders. Each week, we'll talk about the hot quality topics facing hospitals today: Pay-for-performance, transparency, engaging your medical staff, and breaking down the quality barriers that exist in hospital culture. We'll also talk to hospital executives who are indeed quality leaders and learn how their organizations have achieved excellence.

I look forward to our weekly conversations and I hope you'll e-mail me with ideas and insights to make our "chats" beneficial for all of us.


Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.

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