Abstract

Almost 300 people attended the 2000 ICSI/IHI Colloquium on Clinical Quality Improvement, "Cultivating Quality--Growing and Nurturing Clinical Quality Improvement in Health Care," May 11-12, 2000, in St Paul. Sponsored by the Institute for Clinical Systems Improvement (ICSI) and the Institute for Healthcare Improvement (IHI), the annual event featured three keynote speakers--David M. Lawrence, MD (Kaiser Foundation Health Plan, Inc, and Kaiser Foundation Hospitals, Oakland, Calif): Martin P. Eccles, MD (University of Newcastle-upon-Tyne, England); and Maureen Bisognano (IHI). PATIENT SAFETY AND THE U.S. HEALTH CARE SYSTEM: David M. Lawrence, MD, said medicine is trying to use new technologies and meet consumer expectations with a delivery system--a "chassis"--that was designed for another time and a different science. He also described the four chassis stages in medicine. Martin P. Eccles, MD, presented a researcher's view of the reasons evidence is not used in daily practice, a range of strategies for promoting its use, and the strengths and shortcomings of this evidence base. He discussed three areas of evidence--clinical strategies, behavior change strategies--and systems for delivering these strategies--and how they can be used for implementation of practice changes. GETTING CLOSER TO OUR PATIENTS: Maureen Bisognano outlined three methods that should be in every health care provider's improvement portfolio: reducing the defects a patient experiences, eliminating costs, and pursuing innovation. Focusing on defects and waste reduction will free up funds for innovation. It is the responsibility of leaders to push for innovation on behalf of patients, or patients will take their business elsewhere.

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