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Implementation: The Quality QUANDARY

Professor Jonathan Benger Chair, Clinical Effectiveness Committee, CEM. Implementation: The Quality QUANDARY. Guidelines Best Practice Recommendations Standards Indicators. How do we know if they do any good?. Locker TE, Mason SM. BMJ 2005;330:1188-9.

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Implementation: The Quality QUANDARY

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  1. Professor Jonathan Benger Chair, Clinical Effectiveness Committee, CEM Implementation: The Quality QUANDARY

  2. Guidelines Best Practice Recommendations Standards Indicators How do we know if they do any good?

  3. Locker TE, Mason SM. BMJ 2005;330:1188-9

  4. Locker TE, Mason SM. EMJ 2006;23:558-9

  5. Mid Staffordshire NHS trust left patients humiliated and in pain • Francis inquiry finds 'shocking' failures in care as hospital focused on cutting costs and hitting government targets • guardian.co.uk, Wednesday 24 February 2010 17.19 GMT • An independent inquiry found today that there were "shocking" systematic failures of hospital care in Mid Staffordshire that left patients routinely neglected, humiliated and in pain as the trust focused on cutting costs and hitting government targets. Relatives of those who have died at Stafford general hospital stand in front of a tribute wall. The hospital left patients in pain, says an inquiry.

  6. Heavy enforcement Data proliferation Perverse incentives Gaming Hitting the target, but missing the point Quality indicators

  7. CEM Strategy • Guidelines and Best Practice Statements Turn into… • Standards Turn into… • Audit and data criteria Turn into… • National audits Turn into… • Comparative data

  8. Comparative Data • Lowest performers are highly challenged Which is good… And bad… • What does the ED do? • What does the College do? • What does the Regulator do?

  9. Heavy enforcement Data proliferation Perverse incentives Gaming Hitting the target, but missing the point Comparative data

  10. Jonathan.Benger@uwe.ac.uk Implementation: The QUALITY Quandary

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