April 30, 2001
Shine enlightens Emory on health care
By Eric Rangus email@example.com
Exploring the problems of the nations health care system and identifying the paths health care workers must take to fix it were the themes of the final Future Makers Lecture of the academic year, delivered April 25 by Kenneth Shine, president of the Institute of Medicine (IOM), in WHSCAB Auditorium.
Crossing the Chasm in Health Care: Achieving Quality Care for All
Americans, the title of Shines speech, is also the name of
a recently released IOM study commissioned to investigate the gap between
the nations health care needed and health care received.
It was too big and too broad to be ignored, Shine said. So
large, he continued, that the perceived gap was renamed a chasm.
This study now provides the leadership agenda to move forward toward
the kind of system and the kind of care wed all like to see,
said Michael Johns, executive vice president for Health Affairs, in his
introduction. Now in its fourth year, Future Makers is sponsored by the
Woodruff Health Sciences Center.
A cardiologist and physiologist, Shine is a clinical professor of medicine
at the Georgetown medical school and former dean and provost for medical
sciences at the UCLA School of Medicine. He was elected IOM president
Doctors often dont know how to measure quality, Shine
said. Physicians tend to equate quality with the training and knowledge
of other physicians. Actually, the quality of care is that
given to patients. It is not necessarily dependent on the skill of physicians.
Shine then gave several examples about how faulty health care systems
resulted in less-than-quality care.
He told the story of one hospital that was experiencing a high mortality
rate of emergency room patients who needed surgery.
The reason for this, he said, is that the hospitals surgeons wanted
the patients brought into surgery as quickly as possible; hospitals with
lower mortality rates stabilize the patients first, then wheel them to
Shine characterized this as a systemic problem. The doctors were
highly skilled, he said, but there was nothing they could do to
improve the problem without changing the system.
Shines elixir for the countrys health care system included
a six-point agenda to recreate a system that is safe, effective, timely,
patient-centered, efficient and equitable. We need to translate
what we know into better care for patients, Shine said in conclusion.
Its a big challenge, but I think we can do it.
The IOM was created in 1970 and is a part of the National Academy of
Sciences. Although created by the federal government, IOM is an independent
body that acts as an advisor to the government on scientific and technical
matters. Johns is one of IOMs elected board members.
Following his hour-long address, he took several questions from the audience.
Shines full lecture is available online at www.emory.edu/WHSC/HSNEWS by following the links to the Future Makers Lecture Series.