Ensuring Quality Health Care
Broadening the Focus
Quality-Related Initiatives to Improve Community Health Status
Presenter:
Michael Stoto, Ph.D., Director, Division of Health Promotion and Disease Prevention, Institute of Medicine, Washington, DC.
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While the focus of previous workshop sessions was on efforts to measure and improve the
quality of care provided by health plans, this session sought to place health plan activities in the
context of broader efforts to improve overall community health status.
Two Institute of Medicine (IOM) committees that examined this issue were described, one of which explored
the potential of developing performance measures to promote improvements in the public's health.
Recognizing that health status is influenced by a broad range of factors, the
committee's recommendations to develop performance measures were described in the context of a broad-based
community health assessment, prioritization, and improvement process. The health
of the community must be a shared responsibility, which is best served by forming partnerships
across a wide range of organizations, including health plans and public health agencies.
Also noted was the importance of establishing both specific objectives in a collaborative way for each of
the entities involved, and measures to assess their progress in meeting these objectives.
To illustrate
the types of measures that might relate to the activities of health plans, the presenter shared several
examples of prototype measures developed by the IOM committee partnerships in different areas
(e.g., infant health, immunizations, and breast and cervical cancer), but stressed that the priority
health areas and measures for a given community should be developed in the context of a broad-based, community-specific process.
References
Durch JS, Bailey LA, Stoto MA. Improving Health in the Community A Role for Performance Monitoring. Washington, D.C. National Academy Press, 1997.
Stoto MA, Abel C, Dievler A. Healthy Communities: New Partnerships for the Future of Public Health.
Washington, D.C. National Academy Press, 1996.
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