Abstract
Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. These achievements are all the more notable given Israel's modest overall spending on health care and because they have accrued to virtually the entire population of the country.Health care systems in most developed nations around the world find themselves in a similar position today with respect to health care quality. Despite significantly increased improvement efforts over the past decade, routine safety processes, such as hand hygiene and medication administration, fail routinely at rates of 30% to 50%. People with chronic diseases experience preventable episodes of acute illness that require hospitalization due to medication mix-ups and other failures of outpatient management. Patients continue to be harmed by preventable adverse events, such as surgery on the wrong part of the body and fires in operating theaters. Health care around the world is not nearly as safe as other industries, such as commercial aviation, that have mastered highly effective ways to manage serious hazards.Health care organizations will have to undertake three interrelated changes to get substantially closer to the superlative safety records of other industries: leadership commitment to zero major quality failures, widespread implementation of highly effective process improvement methods, and the adoption of all facets of a culture of safety. Each of these changes represents a major challenge to the way today's health care organizations plan and carry out their daily work. The Israeli health system is in an enviable position to implement these changes. Universal health insurance coverage, the enrolment of the entire population in a small number of health plans, and the widespread use of electronic health records provide advantages available to few other countries.Achieving and sustaining levels of safety comparable to, say, commercial aviation will be a long journey for health care--one we should begin promptly.This is a commentary on http://www.ijhpr.org/content/1/1/3/
Highlights
Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years
Can we be satisfied when the failure rate on nearly half (13) of the measures in 2009 was greater than 30%? Shouldn’t we expect that all patients who could benefit from a particular health service will receive it? In general, the findings of Jaffe and colleagues mirror the state of health care quality in ambulatory and hospital care around the world–some progress in some areas over the past decade, the creation of some pockets of excellence, but many more areas of mediocrity
How confident are we in the quality of the measure? Said another way, how sure are we that improving performance on the measure will lead directly to improved health outcomes for patients? How much will it likely cost to achieve those improved outcomes? Are the benefits commensurate with the costs?
Summary
Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. Commentary In this volume of the Journal, Jaffe and colleagues report data on the quality of community health care in Israel that demonstrate both improvement and comparability with similar data from the United States and Europe. Improvement in some areas is remarkable and so is the achievement of comparability with other health care systems on important measures
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