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NQF Founder: Quality Measure Science Still 'Immature'

Cheryl Clark, for HealthLeaders Media, May 5, 2011

What can be done, then, to change the situation? "I take the perspective that there's much more that healthcare could do to prevent these kinds of things than some people would agree with," Kizer explains. "Did they [the care provider(s)] try to have contact with the patient every day to measure their weight?"

The way to manage this increased intensity on quality, Kizer says, requires providers to adopt "a team activity."

  • Does the health provider have teams in place to support the patient at home so he doesn't end up back in the hospital?
  • Is anyone calling the patient to see if they took their medications? And ask if they are okay?
  • Is anyone asking how the patients are doing on their diets?

"It's unrealistic that the doctor should be doing that, as nice as that might be," he says.

Back in February, Kizer, 59, was tapped to direct the new Institute for Population Health Improvement at University of California at Davis Health System, an entity that will tackle pressing issues dealing with how we find strategies to improve health in the community, including how to measure them.  That's a whole new field of science.

Kizer says he's happy that hospital care is finally being measured in a meaningful way, though he realizes that many providers think the science isn't quite there yet. Still, he believes the most important revelations about quality of care are still to come.

"One way of keeping measurements from being good is to not use them, which some people would like to see," he acknowledges. "But we have a saying: 'Nothing makes a performance measure better than when it starts being used.'

"Because once it is used in the real world, you find out all the little nuances;  the real world situations that may not have been thought about when it was being designed.

Kizer believes that for those who think value based purchasing is a bad idea that can't last, and have the attitude that "this too shall pass,' are very mistaken. "It may not make some people very happy, but a few years from now, we'll be talking about amounts of money that are much higher than 1% to 2%."

I think he's absolutely correct.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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