Improving clinical outcomes through internal benchmarking and quality targets

As healthcare providers continually strive to improve quality and increase cost efficiency: patients (and payors) still require and deserve convenienc e and extensive personal health-related information. The nephrology communi ty, in particular. is facing numerous challenges. The end-stage renal disea se (ESRD) population is increasing, er en as is is becoming more complicate d The advancing age in the general population is being mirrored in the ESRD population, with 45% of the patients being over the age of 65 Patients wit h diabetes represent 39% of the ESRD patients, and at a 10% annualized rate of change, diabetes represents one of the fastest-growing causes of ESRD. Not unexpectedly, the costs of caring for these patients have increased. Co nsidering that the ESRD program represents 0.8% of Medicare beneficiaries w hile consuming 5.5% of the revenues, if is unlikely that ESRD expenditures will continue to elude legislators. To reduce overall healthcare expenditur es and improve the quality of care, the process by which cure is delivered needs to be examined and redesigned. Previous attempts to improve quality t hrough externally, imposed targets and a quality assurance (QA) approach ha ve generally been unsuccessful. In contrast by employing continuous quality improvement (CQI) techniques, sustainable changes in the process of care c an result in cost-efficient, high-quality cure. The purpose of this study w as to assess the ability of internal benchmarking and quality targets when used in conjunction with CQI techniques to correct common causes of poor qu ality in the dialysis setting.