Baylor Health Care System Quality Initiatives: A View from the Healthtexas Provider Network

Abstract

Ayoung woman rushes into a doctor’s office, clutching her chest and groaning with pain. The pain began that morning, awakening her from sleep, and has increased over the past several hours. She spent the preceding day laboring in the yard but does not remember a strain or injury. The lady appears anxious and short of breath and has fine beads of sweat on her forehead. Her husband pleads for someone to do something. This scenario is common in many physicians’ offices. Her pain may be due to a heart blockage, a blood clot, or a muscle strain. Her problem will be dealt with expediently and with a high degree of success. Yet, the physician who solves the young lady’s problem may miss a more serious condition. She could be harboring an early cervical cancer. She might have an early breast cancer. Or, she may step on a rusty nail next month and contract tetanus. Each of these problems must be considered and addressed early for optimal care. Unfortunately, our current systems often overlook preventive strategies in the face of acute illnesses. Can we redesign our encounters with patients to ensure that appropriate preventive measures are consistently performed? It’s a daunting task and one that can potentially distract the physician from focusing on the chief complaint of the patient—the reason the patient comes into the office in the first place. Additionally there are the pressures of managed care, coding documentation, and time constraints. Preventive measures are important. The mortality rate of