Aligning quality improvement to population health

Abstract

Most examples of the use of quality improvement (QI) methodologies currently come from acute care. They often demonstrate more efficient processes, improved staff morale and patient satisfaction and better health outcomes for specific service users but they are rarely able to indicate whether a service improvement has impacted on the population as a whole by targeting those most in need, improving access or identifying which aspects of service provision should be top priorities for improvement. One way of addressing this is to set QI in the context of whole populations. The practicalities of introducing a more strategic approach are not easy, and it requires innovative new partnerships, but there are well-established proxy measures of healthcare needs. Mapping data geographically can help identify ‘hot spots’ of high incidence or prevalence or areas of low service usage where high need would be expected. Adopting this approach has significant potential for ensuring that services are provided more appropriately and efficiently and for improving population health overall. The benefits that modern medicine can bring to society have not been fully realized. The knowledge, therapies and technology is there, but we fall down on implementation. We have systems that are unreliable from day to day and which do not deliver complete care. In the USA, for example, patients receive just over half of the interventions they need, regardless of insurance status [1]. The shortfall is …