President's Message
The Best Health System
in the World

1. What's Wrong: A Snapshot
2. Lessons from the Scorecard
3. What's Right: A Blueprint for Change

Printable version of this article
(18 pages)

Unreliable Care and Processes. More than six years ago, the Institute of Medicine published its landmark report, To Err Is Human, calling for implementation of systems to ensure patient safety.(1) Yet, one-third of American patients surveyed in the Fund's 2005 international survey said that in the last two years a medical mistake or a medication or lab test error was made during their care. In order to reach the levels of reliability achieved by the benchmark countries, Germany and the United Kingdom, the U.S. must reduce its error rate by one-third.
Insufficient Focus on Patients' Preferences. Patient-centered care is care delivered with the patient's needs and preferences in mind. When care is both patient-centered and delivered in a timely manner, patients are more likely to adhere to treatment plans, to be fully engaged in care decisions, and to receive better care overall.
In the mid-1980s, The Commonwealth Fund became one of the pioneers in the patient-centered care movement, calling for regular surveys of hospitalized patients to learn from their experiences with care. Among 254 hospitals voluntarily reporting results in 2005, there was a substantial differential between the top- and bottom-performing groups of hospitals on how well they manage pain, respond when patients press call buttons or need help, or explain medi-cations and possible side effects. In the fall of 2007 the Medicare program will require all hospitals to report standardized patient-centered care survey results.
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