Summary: Current quality measures focus on care upon admittance and care at end of stay and/or at discharge but ignore all aspects of care during the patient's stay, says Dr. Dale Bratzler, medical director of the Hospital Interventions Quality Improvement Organization Support Center. He identifies several areas that if given attention may result in better transitions of care, including the patient's discharge from the hospital. A cultural shift toward accepting quality ratings as part of practicing medicine is occuring in healthcare organizations from the top down, he observes, and believes that team-based training -- both for medical students and current doctors and nurses -- will help ensure high-quality care for patients. Bratzler will provide a brief overview of the potential unintended consequences of public reporting that could lead to patient harm in both direct and indirect ways. Bratzler will also describe how avoiding these unintended consequences of performance measurement requires careful attention to the development of measure specifications and setting realistic goals for improvement. Conference participants will then have the opportunity to probe for more details and bring to the "table" the areas of concern in their organization during a September 6, 2007 audio conference, Ensuring the Benefits of Public Reporting and Pay-for-Performance Programs Outweigh the Unintended Consequences.
