We all know that
change for its own sake is seldom wise. The medical pioneers who founded
the Kaiser Permanente (KP) organization effected a revolutionary change
in the established system of delivery of medical care. Their success
and the fact that the KP system continues to thrive is a tribute to
the value of incessant examination of our methods. This philosophy has
always been clear to our leaders and to most health practitioners in
the KP organization. Improvements serve both to increase the quality
of care to our patients and to ensure survival of our organization in
the competitive health care marketplace.
James A
Vohs, MD, President, CEO, and Chairman of the Boards of Kaiser Foundation
Health Plan, Inc, and Kaiser Foundation Hospitals, was a creative champion
of innovation and improvement in Permanente Medicine. Upon his retirement,
the James A Vohs Award for Quality was established to recognize and
honor projects that advance the quality of care, showcase innovative
techniques, produce transferable knowledge, and underscore the value
of multidisciplinary teamwork. Annually, each KP Division is invited
to nominate one or two projects. The award is presented for the project
best representing an established effort to improve quality through objectively
documented and institutionalized changes in direct patient care. The
selection criteria include demonstration of measurable improvement in
care and potential for transfer to other locations as a "successful
practice." Thus, the benefits ultimately extend to large numbers
of KP members nationally, to the general community, and to the entire
health care industry.
We present
in this issue the 2003 Vohs award winners. The KP Single-Region award
was given to "The Palliative Care Program--Southern California."
This interdisciplinary, home-based program offers care for patients
with an estimated 12-month prognosis for survival; the three most common
diagnoses being cancer, heart failure, and lung disease. The program
demonstrated effectiveness in improving symptom management, offering
psychosocial support, and reducing costs. The KP Multiple-Region winner
was "Improving Appropriate Prescription Drug Use to Best Practice--Northern
and Southern California." Targeting antibiotics, allergy drugs,
and arthritis medications, the program established committees to monitor
their use and to engage in instructional educational approaches to encourage
appropriate prescribing.
Publication
of the Vohs winners fits the mission of The Permanente Journal "to
promote the delivery of superior health care through the principles
and benefits of Permanente Medicine." With this issue, we have
published 15 Vohs projects over a five-year period. They represent eight
different KP Regions and most major medical specialties, including:
1) preventive practices (pediatric practice, immunizations, breast cancer),
2) management of chronic illness (asthma, diabetes, heart disease, cancer,
COPD, sickle cell disease), 3) computerization of medical data, and
4) drug utilization. A number of Vohs projects have already rapidly
spread to use by other regions.
The process
for nomination has some local variation and each KP Division has contact
liaisons easily located through its regional quality representative.
Nominations need approval by the KP Division President and by the Medical
Director. Applications are due September 1st each year. There is no
monetary gift with the James A Vohs Quality Improvement Award. Winners
and runners-up present their projects at a reception hosted by the KP
Boards of Directors, Division Presidents, and other Program Officers.
The awardees also receive publicity through the Quality Notes newsletter
and through local, state, and national press releases.
A Vohs
Award Selection Committee includes Board of Directors members, a Vohs
family member, Chairman Bob Crane, Program Office quality representatives,
a Permanente Federation representative, and two nonvoting Program Office
quality representatives. This Committee announces its selection at the
December Board of Directors meeting, and team members are contacted
by phone within the next day or two. The recognition ceremony takes
place at the March Board of Directors' meeting.
The possibilities
for projects are limited only by the imaginations of our health professionals.
Part of our purpose in publishing these projects is the hope that they
will encourage others to present projects for consideration.
