International Journal for Quality in Health Care 15:i1 (2003)
© 2003 International Society for Quality in Health Care
Preface
In October 2001, a month after terrorist activity dramatically reduced international travel, the International Society for Quality in Health Care (ISQua) convened its fourth annual International Indicators Summit in Buenos Aires. The Agency for Healthcare Research and Quality provided a grant to fund speakers to travel to the Summit and to disseminate some of the papers presented at the Summit in this supplement to the International Journal for Quality in Health Care. Attendees who braved the circumstances heard two days of papers on the topic of quality indicators with a special focus on medication safety presented in English with simultaneous Spanish translation. This supplement includes six papers by presenters at that Summit, on similar topics, but in all cases the authors have updated and/or provided new information for the Journal’s readers. The introductory piece by Lee Tregloan, CEO of ISQua, describes ISQua’s previous activities and role in convening an international forum to exchange knowledge and ideas about quality indicators.On the first day of the Summit, Jan Mainz, who directs Denmark’s National Indicator Project, refreshed our understanding with an overview of the field of quality indicators. Dr Mainz has provided two papers based on his presentation. The first, ‘Defining and classifying clinical indicators for quality improvement’, is published in the December 2003 issue of this journal. The second, included here, is a methodologic primer that will be a timely reference for anyone considering the development of new quality indicators.
David Ballard, President of ISQua 2001–2003, moves the discussion to the level of the healthcare institution and describes the Baylor Health Care System’s efforts to develop and use a performance profile of quality indicators. The resulting manuscript included in this supplement will be helpful to other institutions undertaking such efforts.
As a result of travel restrictions imposed by the US government following the events of September 11, 2001, Dr Gregg Meyer, then Head of the Agency for Healthcare Research and Quality’s Office of Quality Improvement was unable to attend the Buenos Aires Summit. Dr Meyer sent a presentation which was shared with the Summit audience, and has now prepared for this supplement a paper based on that presentation reviewing the funding provided by the Agency for Healthcare Research and Quality for Patient Safety programs. As one of the premier funding agencies in the world focusing on this topic, the Agency’s funding activities and plan will be of interest to other countries whose governments are undertaking efforts to assess and improve patient safety, as well as to other funding agencies in and outside of the United States that are considering support for patient safety initiatives.
Day two of the Summit focused on patient safety, and medication safety in particular. Professor David Bates presented previously published data comparing different methods of detecting adverse drug events. Limited time prevented him from reviewing additional material on how Partners Health Care is approaching its patient safety efforts; this is now described by Frankel et al. in this supplement, including how Partners is organizing its ‘Executive WalkRoundsTM’ intervention. Other institutions embarking on similar activities will find it useful to read about how a premier healthcare system in the US is approaching patient safety, and how it intends to evaluate the impact of its activities.
In the following presentation, Dr David Classen warned the audience about the importance of managing adverse drug events and reactions rather than focusing only on what is currently known or thought to be an error. The manuscript that he has co-authored in this supplement elaborates on this point of view, and enhances our understanding of how to protect patient safety for the future.
Finally, Professor Bill Runciman and colleagues from the Australia Patient Safety Foundation present a wealth of qualitative information from many sources about the types of errors and adverse events reported in Australia. Although many of the systems cited in the paper relied upon reporting systems rather than random sampling, the remarkable consistency of findings across several different types of reporting structures makes it more likely that the most frequently reported adverse events are important issues and valid quality and safety concerns. These are likely to be similar to the important problems in the rest of the world, especially in nations with similarly developed healthcare systems.
Since the Buenos Aires Summit, another Indicators Summit has taken place in Paris, France, in November 2002. Readers who find this supplement informative may wish to watch for the papers by presenters at that symposium, which are to be published in a supplement in volume 16 of the International Journal for Quality in Health Care in the spring of 2004.
Director, Quality of Care Research, The Johns Hopkins University
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