I N T E RV I E W When 100 Percent Reliability Is Required Nothing Is Taken for Granted “ The goal over the last 15 years has been to better define quality by actual measures, to collect the data from hospitals and to report it publicly.” It should go without saying that we all want the highest-quality healthcare. But what does that mean? UCLA Health has made quality and safety the top priority, and has joined with leading hospitals, physician groups, employers, health-insurance associations and others to focus on monitoring and improving healthcare quality and efficiency through national evidence-based measures of evaluating, standardizing and comparing the performance of hospitals, physicians and other providers. Thomas Rosenthal, UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) MD, chief medical officer for UCLA Health, discusses the quality movement and how UCLA has responded. How do you define quality? Well that’s the $64,000 question. If you go back 20 years, quality simply meant all of us doing our best. The presumption was that if you trained people well, put them in good environments, made sure they were professional and highly motivated, and got good results, that was quality. But a pair of influential reports by the Institute of Medicine, released beginning in 1999, concluded that that was not enough — that if you didn’t approach hospital care in a more systematic way, you could cause preventable harm and death to patients. That was the basis for the beginning of the quality movement. What has characterized that movement? The goal over the last 15 years has been to better define quality by actual measures, to collect the data from hospitals and to report it publicly. The idea is not only to measure quality, but also to use those measurements to improve performance. What are some of the key areas that are measured, and what is UCLA doing to improve its own performance? There is a great deal of underreporting