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Support for Efforts by Health Care Professionals to Improve Quality

Federal policy can make a big difference in the quality of care that patients receive. Yet excellence in health care comes not from Washington but from health care professionals working with patients to provide the best possible care. As the health care treatments available become more complex and advanced, it will become even more important to create an environment that encourages hospital-, physician-, and community-based efforts to eliminate medical errors, prevent complications, and avoid unnecessary costs by making sure that the right treatment is used quickly and effectively.

Many such local initiatives have demonstrated proven benefits, such as: 30% efficiency gain in intensive care and even larger reductions in postoperative complications at LDS Hospital in Salt Lake City; large reductions in the time to effective treatment for critically ill emergency room patients at Overlook Hospital in New Jersey; and substantial reductions in mortality for bypass surgery patients treated in a group of Northern New England hospitals.

But too often, efforts by health care professionals to improve quality are impeded by liability concerns, which have been aggravated by dramatic increases in malpractice premiums in many parts of the country this year. Providers are afraid to take steps to identify ways to improve care, for fear that their efforts to improve quality and safety will be used against them in litigation. And in many cases, Medicare pays health care providers less when they deliver better care that prevents costly complications.

The President wants to provide better support for health care professionals working to deliver safer and more effective care. The Administration is re-directing Medicare's Quality Improvement Organization (QIO) program to focus more on safety as well as quality, and to increase support for state, local, and community initiatives to improve the quality and safety of care delivered by healthcare providers to Medicare beneficiaries. The President also proposed an increase of $5 million, for a total of $60 million, to applied research and demonstration projects dedicated to eliminating medical errors and improving patient safety. The Administration will also issue regulations in 2002 to require bar coding of medications, which will help health care providers avoid medication errors.