Why implement CDM Quality Care?

 

A NEED FOR NEW APPROACHES TO QUALITY IMPROVEMENT

The management of chronic diseases, such as COPD, could benefit from new approaches to quality improvement, that would include the continuous assessment of patient care delivery and practices (specific interventions, programs, pathways), proper monitoring and continuous improvement.

 

Quality improvement in the past

Traditionally, the quality of patient care would be improved through informal professional development: case reviews, relevant sources of knowledge, and the consideration of perceived errors in care delivery.

This approach often had many weaknesses:

  1. the content would normally reflect acute care practices and serious adverse events;
  2. there was no systematic monitoring of patient care processes or the variation in outcomes over time;
  3. in many cases, discussions tend to be hierarchical, with staff rarely criticizing the care provided.

In addition, a systematic focus on individual responsibility and identifying errors may be perceived as generating a punitive, negative, or distrustful work environment.

 

With an eye to the future

We need to embrace more innovative approaches to quality improvement. Collaborative projects, such as "CDM Quality Care" could be the stepping stone to implementing recognized systematic approaches to chronic disease management, such as DM.

This would mean taking up the challenges of three major trends in health care organization:

  1. increasing focus on chronic disease patients and their needs, based not only on certain acute events, but on the underlying chronic disease itself;
  2. shifting from fragmentized care to integrated evidence-based disease management, supported institutionally through strategic partnerships; and
  3. implementing systematic evaluations  to help guide a cost-conscious approach to choosing the best clinical practices, owing to increasing pressures upon scarce economic resources.

The management of chronic diseases, such as COPD, could benefit from new approaches to quality improvement. This could then be used for other chronic diseases.