The Lucian Leape Institute at the National Patient Safety Foundation today released a report on care integration that highlights the issue as a national priority for improving patient safety and the efficiency of the US health care system. Order from Chaos: Accelerating Care Integration is the result of a Leape Institute Roundtable that brought together leading experts in the fields of patient safety and health system improvement.
The report defines what integration should look like in the health system of the 21st century, highlights ongoing barriers to better coordinated care, and outlines opportunities for improvement.
"One of the greatest challenges in the effort to provide higher quality, affordable health care is finding ways to integrate the wide array of services that patients with serious illnesses need. For too long, patients have been left to their own devices to make sense out of advice and directions from multiple providers in multiple locations. It doesn't work. The system has to do that for them," said Lucian L. Leape, MD, chair of the Institute and a widely renowned leader in patient safety. "Our hope is that this report will spark serious attention to this critical problem."
One of the problems is that there is little agreement about what care integration really means. Order from Chaos looks at definitions, critical components, and two distinct levels of care integration: the process of care and the activities that make up the processes. The report summarizes the chief barriers to care, and points to six areas where progress is needed:
Shared Understanding: Making the link between care integration and patient safety common knowledge among all stakeholders.
Patient Engagement: Involving patients as active participants in care; as reviewers of their care and care processes; and in the design of care processes.
Measures: Creating ways to quantify the links between care integration, clinical outcomes, and financial impact.
Evaluation: Allowing for robust assessment of whether effective integration is actually taking place.
Education and Training: Creating curricula, not only for medical schools, but also for hospital boards and leadership teams, that focus on the issues of patient safety and care integration.
National Spread: Advancing research and technology to support care integration throughout the country.
David M. Lawrence, MD, the retired chairman and chief executive officer of Kaiser Foundation Health Plan, Inc., and Kaiser Foundation Hospitals, served as chair of the Leape Institute Roundtable on Care Integration. A founding member of the Leape Institute, Dr. Lawrence led the effort to produce the current report.
"We are grateful to our Roundtable experts who contributed to this report," said Diane C. Pinakiewicz, MBA, CPPS, president of the Lucian Leape Institute and president of the National Patient Safety Foundation. "On the heels of this work, we are continuing collaborative efforts to promote discussion and innovation around this important topic."
This report is the second in a planned series of reports on issues that the Lucian Leape Institute has identified as top priorities in ongoing efforts to improve patient safety. The first, Unmet Needs: Teaching Physicians to Provide Safe Patient Care, was published in 2010. Subsequent Institute initiatives will address restoration of joy and meaning in professional work and ensuring the safety of the health care workforce; promotion of active consumer engagement in patient care; and provision of fully transparent care.
Besides Dr. Leape and Ms. Pinakiewicz, current members of the Lucian Leape Institute include Carolyn M. Clancy, MD, director, Agency for Healthcare Research and Quality; Janet Corrigan, PhD, MBA, former president, National Quality Forum; Susan Edgman-Levitan, PA, executive director, John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital; Gary S. Kaplan, MD, FACMPE, chairman and CEO, Virginia Mason Medical Center; Julianne M. Morath, RN, MS, chief quality and patient safety officer, Vanderbilt Medical Center; Dennis S. O'Leary, MD, President Emeritus, The Joint Commission; Paul O'Neill, former chairman and chief executive officer, Alcoa, and 72nd Secretary of the US Treasury; and Robert M. Wachter, MD, associate chair, Department of Medicine, University of California at San Francisco.
The Leape Institute is especially grateful to Roundtable members Richard M.J. Bohmer, MD, MBA, Harvard Business School, and Sara Singer, PhD, of the Harvard School of Public Health, Harvard Medical School, and the Mongan Institute of Health Policy at Massachusetts General Hospital, who worked closely with Dr. Lawrence in drafting the report.
A webinar is being planned for early December, with Dr. Lawrence and Dr. Leape discussing the content of this report.
The Lucian Leape Institute at the National Patient Safety Foundation gratefully acknowledges Hospira for its generous support of the LLI Expert Roundtable on Care Integration.
About the Lucian Leape Institute
The Lucian Leape Institute at NPSF, established in 2007, is charged with defining strategic paths and calls to action for the field of patient safety, offering vision and context for the many efforts under way within health care, and providing the leverage necessary for system-level change. Its members comprise national thought leaders with a common interest in patient safety whose expertise and influence are brought to bear as the Institute calls for the innovation necessary to expedite the work and create significant, sustainable improvements in culture, process, and outcomes critical to safer health care.
About National Patient Safety Foundation
The National Patient Safety Foundation (NPSF) has been pursuing one mission since its founding in 1997–to improve the safety of care provided to patients. As a central voice for patient safety, NPSF is committed to a collaborative, multi-stakeholder approach in all that it does. NPSF is an independent, not-for-profit 501(c)(3) organization.
