The History of Quality Reporting
A Succinct Summary of the Major Characters and Events of Quality in Healthcare
Ahem, settle down class. Take your seats.
Yes, very good.
Today, we are learning about the history of healthcare quality efforts. Let’s start with some notable historical figures. Please note, this is not an exhaustive list.
Let us begin.
Notable Historical Figures
Ignaz Semmelweis (July 1, 1818 – August 13, 1865)
In 1847, Ignaz Semmelweis, a Hungarian physician, proposes that the practice of washing hands drastically cuts the incidences of childbed fever, which was common at the time and often fatal. It didn’t work out so well for Ignaz though. Turns out his colleagues vehemently disagreed with his position and threw him into an asylum to boot.
And thus, our story of healthcare quality begins.
Florence Nightingale (May 12, 1820 – August 13, 1910)
Florence Nightingale, an English nurse, was known as the founder of modern nursing. Florence was also instrumental in bringing issues of sanitation to the notice of members of Parliament. Through her research, she demonstrated that bad drainage, contaminated water, overcrowding and poor ventilation were causing a high death rate for the British army in the Crimean War.
To this day, the conclusion of National Nurses Week is celebrated on her birthday.
Ernest Codman (December 30, 1869 – November 23, 1940)
An advocate of hospital reform, Ernest Codman is widely known as the founder of outcomes management in patient care. He was the first doctor to document the patient fully from demographic data, to diagnosis, treatments and outcomes. He would document the steps of the patient on “End Result Cards.” He would then keep up with these patients for at least one year; a practice he called the “End Result Theory.” He believed firmly that tracking of patient outcomes would help discover areas of improving future patient care.
Ernest also helped found the America College of Surgeons and the Hospital Standardization Program, which eventually transformed into The Joint Commission.
I believe you are familiar with them. Yes?
Avedis Donabedian (January 7, 1919 – November 9, 2000)
Avedis was a physician and is widely regarded as the founder of Quality in healthcare. He is most famous for his paper entitled, “Evaluating the Quality of Medical Care” that was published in 1966 and is still widely cited and read today. He was a prolific researcher and writer who primarily focused on defining quality in health systems and proposing models for measurement.
Fun fact. He was also a poet.
“Systems awareness and systems design are important for health professionals, but are not enough. They are enabling mechanisms only. It is the ethical dimension of individuals that is essential to a system’s success. Ultimately, the secret of quality is love.”
Now, let us move on to the next portion of our lesson, a timeline of major events in the history of healthcare quality.
Major Healthcare Quality Events Timeline
1965: CMS is established.
1965: Utilization Review Committees are created.
1972: Experimental Medical Care Review Organizations are created.
1972: Professional Standards Review Organizations (PSROs) are established.
1983: Peer Review Organizations (PROs) replace the PSROs.
1992: Quality Improvement Initiative is proposed.
1994: The National Surgery Quality Improvement Project (NSQIP) is developed.
2003: Surgical Care Improvement Program (SCIP) is established.
2003: The Inpatient Quality Reporting (IQR) program is established.
2006: Physician Quality Reporting Initiative (PQRI) is created.
2008: Congress sets aside $30 billion to get hospitals connected online.
2010: The Patient Protection and Accountable Care Act (PPACA) is signed into law.
2010: Meaningful Use is enacted.
2011: PQRI transitions to the Physician Quality Reporting System (PQRS).
2012: The Value-Based Modifier program is enacted.
2015: MACRA is passed by Congress.
2016: Electronic submission of quality measures is required for the IQR program.
2016: The Quality Payment Program (QPP) is established.
2017: All major regulatory reporting programs require electronic submission of quality measures.
And finally, a study of acronyms
Instrumental Quality Advocacy Groups and Their Formation Years
1847: The American Medical Association (AMA)
1898: The American Hospital Association (AHA)
1928: American Health Information Management Association (AHIMA)
1951: The Joint Commission on Accreditation of Hospitals (Later known as The Joint Commission.)
1961: Healthcare Information and Management Systems Society (HIMSS)
1965: The Centers for Medicare & Medicaid
1970: Institute of Medicine (IOM)
1989: Agency for Healthcare Research and Quality (AHRQ)
1990: National Committee for Quality Assurance (NCQA)
1991: Institute for Healthcare Improvement (IHI)
1999: The National Quality Forum (NQF)
1999: Medisolv is established! (No acronym needed.)
2004: Office of the National Coordinator of Health Information Technology (ONC)
2010: Patient-Centered Outcomes Research Institute (PCORI)
Well, I certainly hope you learned something today. Remember that this quality journey you are on may seem frustrating at times, but to get to where you sit this very day there is a long history of pioneers who came before you and have pushed for reforms to the quality of care. Each big or little push makes our patients, hospitals and providers safer. And you are a part of this journey. Your contributions in your hospital or practice setting continue to fill the pages of this History of Quality reporting novel we write together.
And for my brown-nosing, front-seat sitting, teacher pets, I’ve provided you with extra homework assignments for you to peruse or complete at your leisure.
- 5 Hospital IQR Program Requirements in 2017
- The Joint Commission Requires eCQM Submission in 2017
- 13 Things to Know About the MACRA Final Rule
CMS HOSPITAL INPATIENT QUALITY REPORTING IN 2018
When: Thursday, November 9
1 P.M. ET | 12 Noon CT | 10 A.M. PT
This session will help your hospital to prepare for quality reporting in 2018. You’ll learn about the changes to the CMS Inpatient Quality Reporting (IQR) Program and eCQM reporting to the Joint Commission. We will outline strategies that will help you prepare your hospital for your best, most efficient IQR reporting year yet.
Participants will hear detailed information about what is expected of them on the chart-abstracted side of the IQR program and the electronic requirements as well. You will hear tips for getting your entire team on board for this pivotal year of quality reporting.
When you leave you will:
- How the CMS IQR Program will change in 2018
- The IQR reporting requirements for chart-abstracted and electronic measures
- Tips for preparing your hospital for a successful quality reporting year