207250 A Brief History of Evidence-Based Quality Improvement in Health Care

Tuesday, November 10, 2009: 2:45 PM

Ernest Moy, MD, MPH , Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD
William Freeman, MPH , Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality (AHRQ), Rockville, MD
  
We begin with an overview of health care quality improvement prior to the rise of evidence-based medicine. We describe the genesis of evidence-based medicine and the activities it spawned, specifically clinical guideline development, quality measurement, and evidence-based quality improvement. We track the evolution of each of these disciplines over the past two decades with an emphasis on the role of the federal government.

We next discuss current challenges for evidence-based quality improvement. These include increasing health care consumerism and the need to incorporate patient perceptions of quality, fragmentation of health care delivery and rise of medical homes and care coordination, and the mounting salience of comparative effectiveness and health information technologies.

We conclude with thoughts about how social determinants and the role of community can be better integrated with quality improvement. Synergies could lead to community health planning and health care practices that yield the best outcomes.

Learning Objectives:
1. Identify important historical influences of evidence-based quality improvement. 2. Describe critical challenges to quality improvement. 3. Discuss approaches to integrating quality improvement and community health planning.

Keywords: Quality Improvement, History

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I had primary responsibility for organizing and writing this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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