Hospital-Based Emergency Care – Still at the Breaking Point

Donald Berwick: via Wikicommons

Originally cited from the works of Dr. Donald Berwick and the Institute of Medicine, 6 aims for health care improvement remain prudent today.  The following are the Institute of Medicine’s six aims for health care improvement for both hospitals and all physician services:

1. Safe – Operational systems are in place; implement protocols
2. Effective – Evidence-based protocols are developed collaboratively with physician and nursing input.
3. Patient-centered – Care is delivered to the needs and values of the patient.
4. Timely – Protocols eliminate unnecessary waiting.
5. Efficient – Rapidly identifies AMI/ACS
6. Equitable – All patients receive the same evidence-based protocol.

The Institute for Healthcare Improvement’s vision for healthcare adapted the IOM’s six improvement aims as follows:

1. No needless deaths
2. No needless pain or suffering
3. No helplessness in those served or serving
4. No unwanted waiting
5. No waste
6. No one left out

Although as administrator for CMS, Dr. Berwick’s statements and position were a subject of controversy, his original works, and those of his previous organization remain relatively undisputed.  According to the 2011 edition of the National Scorecard on US Health system Performance, there continues to be substantial erosion in access to care, and rising costs.  The US earned an overall score of 64 out of a possible 100 when comparing national averages with best practice performances benchmarks.

It’s clear that for physician services in today’s healthcare, we are still at the breaking point.