• Service: Audit, Advisory, Management Consulting, Risk Consulting
  • Industry: Healthcare
  • Type: Business and industry issue, White paper
  • Date: 10/31/2013

System governance: assuring quality 

As payers, patients, governments and regulators demand to know more about care delivery and quality, providers are seeking reliable and meaningful metrics. Many healthcare leaders perceive a disconnect between the internal drive for excellence and external requests for measurement and assurance, viewing the latter as unnecessary administration. In the quest to become high reliability organizations, a greater focus on care outcomes can help providers to align these two tasks by reducing complexity and increasing transparency to the benefit of all stakeholders.
“Regulation is much too important to leave to the regulators.”

Niall Dickson, Chief Executive and Registrar, General Medical Council, UK

The one exception to this call for a shift towards outcome measures is safety. Although measurement enhances safety, measuring the successful avoidance of catastrophic events such as wrong-side surgery, complications and medication errors is not a feasible way towards assurance. In common with other high-risk industries, certification is often the preferred way forward, coupled with careful oversight and engaged clinicians.

The tension between internal and external reporting

Many executives note a tension between how they feel their organization should be held to account and how their health systems actually judge them.

Making measurements simpler and more relevant

The most important measures – for both internal and external use – are those that capture the overall outcomes of the care.

Assuring the reliability of reports

Currently, there is an acknowledged lack of clear definitions, registration and handling procedures, and reporting guidelines in healthcare.

Assuring safety

Measuring non-catastrophic ‘negative’ outcomes can be done and is a foundation of safe and high reliable care.

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