Our Point of View

July 25, 2007

Kaiser Permanente Improves Quality Assurance Processes

Providing the highest quality of medical care is Kaiser Permanente's first priority. Thanks to the efforts of the organization's physicians, nurses, and staff, Kaiser Permanente is consistently ranked as the quality of care and service leader in California on numerous independent surveys (see links at right), and — for six straight years — by the state of California's own Office of the Patient Advocate.

The people of Kaiser Permanente understand that there is no finish line when it comes to quality, and the quest for improvement never ends. Kaiser Permamente's unique integrated model for delivering care ensures that when the organization learns better ways of caring for members, it can lead to improvements that impact the lives of millions of people who turn to Kaiser Permanente for care.

Kaiser Permanente and the California Department of Managed Health Care announced on Thursday, July 26, a number of enhancements that will bring greater consistency, standardization and oversight in how Kaiser Permanente tracks, monitors, and reports certain quality and member complaint matters. These enhancements grew out of a survey conducted by the Department of Managed Health Care that focused on administrative and oversight processes in Kaiser Permanente's 29 community-based hospitals in California.

It is important to understand that the survey is not, at any level, about the actual quality of care provided to Kaiser Permanente's members. The Department of Managed Health Care's concerns were about processes, and Kaiser Permanente has either addressed those concerns or is well on the way to addressing them. Kaiser Permanente believes that these corrective actions will enhance the effectiveness of care delivered and will benefit Kaiser Permanente's 6 million-plus members in California.

Kaiser Permanente and the Department of Managed Health Care are aligned on the goal of making sure that every Californian and member of Kaiser Permanente receives the highest possible quality of care. Kaiser Permanente believes the survey was thorough, thoughtful, and comprehensive, and also believes that the organization's immediate response is a clear indication that it has taken the process seriously.

Kaiser Permanente has a long history of evaluating and improving quality assurance processes. The organization has long-established, rigorous peer review processes, and monitors performance through data tracking and reporting to the highest levels of management. Kaiser Permanente currently has several avenues for members to share their feedback on the care they receive, including member service offices located at each of the organization's 29 medical centers in California, the organization's 24-hour member service call centers, and directly through medical group providers.

As an organization that serves more patients than the health systems of 150 countries, Kaiser Permanente recognizes that there are always opportunities to enhance the consistency, clarity, and oversight of our work in this area. The goal is to make Kaiser Permanente's quality assurance programs the best in California and a model for the nation.

As one example of the enhanced approach, a single, consistent and uniform peer review process has been adopted that will ensure that peer review is conducted the same way at every Kaiser Permanente hospital in California. This unified approach evolved from a decades-old system — not unique to Kaiser Permanente and common across the country — under which each local hospital developed its own peer review processes. This newly unified approach will allow Kaiser Permanente to turn 29 already good processes into a single, excellent system.

As part of the Kaiser Permanente oversight efforts developed over the past several years, the organization has developed the ability for Kaiser Permanente's Board of Directors and senior leadership to monitor quality systems from several different viewpoints, allowing them to better understand and improve the overall performance of the organization. This system provides a coherent, top-level view of clinical performance for senior leadership and governance, as well as an integrated, cascading measurement system for quality improvement and benchmarking.

Among the many recent examples of Kaiser Permanente's overall quality of care achievements are:

• Kaiser Permanente's cardiac care programs have resulted in a 30 percent reduction in patient mortality among Kaiser Permanente members in Northern California
• Kaiser Permanente's research into the effects of Vioxx on patient outcomes helped spark a worldwide reexamination of that product, which was subsequently removed from shelves worldwide
• Kaiser Permanente's research into the long-term impact of heart stents resulted in new treatment approaches to heart disease that benefit both Kaiser Permanente members and nonmembers.

Under Kaiser Permanente's unique model, physicians and practitioners from all specialties work together toward a common goal of improving the health of the members Kaiser Permanente serves. This structure has allowed Kaiser Permanente to become an industry leader in preventive care, and in developing clinical standards for the treatment of chronic diseases. It has also put Kaiser Permanente in the forefront in the development of health information technologies such as KP HealthConnect™, which helps providers coordinate patient care between the physician's office, the hospital, radiology, the laboratory and the pharmacy.

Kaiser Permanente hopes these changes provide a model for other health care providers across the state of California.