1. Framing the Issues for Quality and Patient Safety David J. Shulkin, M.D. Professor and Chairman Chief Quality Officer Drexel University School of Medicine DrShulkin@aol.com

2. “If you don’t know where you’re going, you’re liable to end up someplace else” –Robert Mager

3. The Market Model for Quality Stages Stage 2Stage 3Stage 4 Acknowledgement Innovation Reward Differentiation Stage 1 Learning Organization Goal Setting- Defect Free Hospital System (process) Redesign Culture Change Staff Training/Education Data Collection/Analysis Preventive Risk Strategies Leadership Attention Organizational Assessments Provider Response Media Coverage Consumer Interest Consumer Activation Pay for Performance Adoption of Technology Employer Response (Leapfrog) Legislation Availability of Technology Solutions Business Case for Quality/Safety Regulatory Initiatives Malpractice Crisis Data Release (IOM Report) Market Reactions Drivers

4. Stage I- Acknowledgment

5. “All I know is what I read in the newspapers.” - Will Rogers

7. According to a recent Survey respondents had the following concerns: 61 % being given the wrong medicine 58% given medicines that interact in a negative way 56% complications from a procedure American Society of Health System Pharmacists Concerns About Safety

8. Acknowledgment Harvey Fineberg- President of IOM Arthur Miller- Harvard Law Professor, Author, and TV host

9. Stage II- Differentiation

12. Differentiation Suzzane Delbanco- Executive Director, The Leapfrog Group- Purchaser Initiatives for Quality and Error Reduction

13. Stage III- Innovation

14. Technology- Are We Doing All We Can? 92% of Providers believe much more can be done for quality than is being done Effectively using technology: 16% Federal efforts required: 44% VHA Survey, Attendees at International Patient Safety Symposium, 2001

15. Innovation George Halvorson- Chairman and CEO, Kaiser Foundation Health Plan, Author “Strong Medicine and Epidemic of Care”

16. Stage IV- Reward

17. “It is hard to get someone to understand something when his salary depends on him not understanding it.”

19. You can always trust the Americans. In the end they will do the right thing, after they have eliminated all other possibilities. - Sir Winston Churchill - Sir Winston Churchill Are We Really Making Progress in Patient Safety?