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Experts at Panel Discussion Emphasize Quality Care Improvement

APRIL 27, 2006 -- A group of experts whose organizations have been recognized for quality health care explained in a panel discussion Wednesday how health care systems across the nation could improve their quality of care—particularly with Congress' help.

The experts, who were called in by Rep. Patrick J. Kennedy, D-R.I., to share their experiences and advice with him and other congressional staffers, were mostly part of health care organizations that have received the Malcolm Baldridge National Quality Award, a federal award that honors American businesses, educational institutions, and health care organizations that put quality and people first. The American Society for Quality, an international professional association, sponsored the discussion, which was held on Capitol Hill.

Richard Lovering, senior vice president for operations at Robert Wood Johnson University Hospital in Hamilton, N.J., said quality health care like Baldridge Award–winning systems give is an exception in health care because most systems experience a lack of resources. He and other panelists agreed that patients these days "get what they pay for" from hospitals.

"Unless there's some push—from either the federal or state governments—to bring resources that would go across the board, I don't know how to make that common," Lovering said.

While Kennedy said that the money is in the system and the question is whether or not "we are going to channel it into getting better care," he agreed that the federal government isn't doing all it can. He suggested that it distribute more grants to the health care system so the experts can be the ones organizing how funding is being used to improve the quality of health care.

"We don't have the urgency we need up here on the Hill," he said, adding that he doesn't understand why health care isn't a bigger issue, considering it has become the number-one concern in most congressional districts.

Kennedy, however, also asked why more corporate entities aren't getting involved in pushing quality health care and better information technology in hospitals and doctors' offices.

"And yet every other industry has technology that is bringing it into the modern age," Kennedy said, adding that Congress is going to pass a "minimal" information technology health care bill. "We can do much better," he said.

William P. Thompson, senior vice president for strategic development of SSM Health Care in St. Louis, Mo., said that even though large companies, such as General Motors, have the ability to find out which health care systems are offering quality care and could announce that they would no longer pay for hospitals that give bad care, they are unlikely to because it would be limiting their employees' choices.

"If Congress wants to do something, they should mandate disclosure of information," he said, meaning comparative records of health care systems' quality ratings should be widely distributed public information to force hospitals to provide better care.

Thompson also explained what the future of health care should be like with updated technology and equipment—where appointments can be scheduled online with the patient choosing from their physicians' available times and where medical records can be accessed and updated electronically and comprehensively and forwarded to other specialists at the touch of a button.

"We can do it in other sectors," he said, pointing to the ability to buy an airline ticket and choose a seat online. "The capable systems are there, we just have to find the time and money . . . to implement them."

G. Richard Hastings, president and CEO of Saint Luke's Health System in Kansas City, Mo., said that at his hospitals every employee has a performance management plan, where the incentive is a better salary for better performance in everyday duties.

"You can't have a system without an economic incentive," he said. Deborah Baehser, senior vice president for patient care services at Robert Wood Johnson University Hospital, agreed and said that she thinks "paying for performance is moving in the right direction" of improving health care systems.

Kennedy also emphasized that aligning incentives is the key to getting health care systems to provide better care.

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