Are Quality Metrics Missing the Point?

Charlotte Yeh, MD, emergency physician and chief medical officer for AARP Services, herself became a hospital patient after being hit by a car while crossing a street in Washington, DC. Despite excruciating backside and knee pain, she wasn’t seen by an orthopaedist for almost 48 hours. In her recent Health Affairs critique of the health care system she encountered, she argues that medical metrics need to be rebalanced to include both the clinical and personal. Rebalancing will require three things, she said:

De-emphasizing the culture of testing. “When a test…is the centerpiece of care strategies, patient care can be compromised,” Dr. Yeh writes.

Making care personal. During four days in the hospital, no one asked Dr. Yeh how she was doing. By contrast, while in a post-discharge rehab facility, she said “personalized patient care was the rule, not the exception.”

Measuring patient-reported outcomes. No one in the hospital seemed to care about Dr. Yeh’s reports of her own condition. “Going forward,” she writes, “quality metrics should give more weight to patient-reported outcomes.”

In turn, achieving those three things will require that all clinicians focus on “mastering the skills of listening, empathy, and patient partnership,” Dr. Yeh concludes.

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