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Evolution of Healthcare Quality Improvement Efforts in U.S.

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Describe the evolution of inspecting and improving quality in the healthcare industry.

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Over the last century, much work has been done in the United States to improve quality in healthcare delivery, culminating with the recent passage of the Affordable Care Act.

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Our present emphasis on healthcare quality improvement and patient safety has evolved over the past several decades to reach the current state of quality reporting and improvement efforts. The modern quality movement in healthcare can be traced to the 1960's, with the passage of the Medicare program. At that time, Congress established a series of actions aimed at ensuring the quality of care provided for Medicare beneficiaries. The first was a set of conditions called "Conditions of Participation," that outlined certain elements considered necessary for the provision of quality healthcare by participating hospitals, such as staff credentials, 24-hour nursing services, and utilization review. Utilization Review Committees and other professional review organizations were established, with limited success.

During this period of time, in addition to governmental efforts, healthcare ...

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