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Academia and Clinic: Joanne Lynn, Mary Ann Baily, Melissa Bottrell, Bruce Jennings, Robert J. Levine, Frank Davidoff, David Casarett, Janet Corrigan, Ellen Fox, Matthew K. Wynia, George J. Agich, Margaret O'Kane, Theodore Speroff, Paul Schyve, Paul Batalden, Sean Tunis, Nancy Berlinger, Linda Cronenwett, J. Michael Fitzmaurice, Nancy Neveloff Dubler, and Brent James The Ethics of Using Quality Improvement Methods in Health Care Ann Intern Med 2007; 0: 0000605-200705010-00155-47 [Abstract] [Full text] [PDF]

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Ethics and quality improvement oversight

Vijay Rajput   (8 May 2007)

Ethics and quality improvement oversight 8 May 2007
Vijay Rajput, MBBS, FACP UMDNJ- Robert Wood Johnson Medical School, Camden, NJ 08103 Send rapid response to journal: Re: Ethics and quality improvement oversight rajput-vj{at}cooperhealth.edu Vijay Rajput	The article on ethics oversight of quality improvement methods suggested for customized institutional review board process for the overlap category (1). I would like to suggest that we must provide oversight to all outcome based studies on quality. We are aware that poor quality can be too much care, too little care or wrong care; all of them jeopardize the patient safety. All these years we have been focusing on structural and technical process quality and not outcome. The outcome, by large offers evidence of change in patient health status, which validates effectiveness and quality of care. The current movement with “pay for performance” as new strategy in health care finance for controlling cost and improving quality. We will need more neutrality and detachment in studies on quality of health care. We must provide IRB or institutional oversight on these studies. Donabedian has suggested that we need to ask, “ What goes on here?” rather than, “What is wrong; and how can it be better?”(2) There will be more need for oversight on values in health care with both research and quality. 1 Lynn J et al. The ethics of using quality improvement methods in health care. Ann Intern Med. 2007; 146:666-673 2. Donabedian A. Evaluating the quality of Medical Care. The Milbank Quarterly.2005; 83:691-729 Conflict of Interest: None declared