Patient safety and system design

Donaldson was project co-director for the IOM Committee that issued the reports, To Err is Human and Crossing the Quality Chasm. To Err is Human provided insight about how systems of care can lead to error or support safety. Our experience can provide practical assistance in designing work.

The Chasm report outlined the six Aims and “New Rules” for health care and described how organizations and other public- and private-sector entities can support such change. MSDHealth can assist in developing frameworks, setting priorities, and drafting white papers on improving quality of care and patient safety.

Care coordination

We have experience developing, testing core treatment documents such as planning, and treatment summaries to improve the availability of information to any treating clinician and patients in active treatment, or transitioning from active treatment.

Cancer care is complex, typically involving many settings, departments, oncologic and non-oncologic specialties, and other health professionals, over varying lengths of time. Oncology treatment summaries can improve the coordination and efficiency of care by ensuring that concise, accurate, and timely information is available to treating clinicians and their patients at the time of decisionmaking.

Using patient-reported outcomes (PROs) in clinical oncology

We help organizations and practices anticipate challenges to the use of PROs in clinical practice including physician, patient, system, and administrative issues.

Patient-reported outcomes -- including health-related quality of life -- are any "report coming from patients about a health condition and its treatment” (FDA guidance, 2006). PROs include quality-of-life reports and patient experience. PROs may include symptoms of disease or side effects of treatment, reports about physical, mental, and social functioning, and the effectiveness of supportive care. They can be useful in monitoring care and adjusting treatment and supportive care, understanding treatment effectiveness of groups of patients, and increase patient understanding and self-care.

Ways of incorporating systematic reporting about health-related quality of life using new electronic systems (e.g., web-based, phone, PDA) are being developed and tested for routine use in practice. These systems can minimize patient and clinician burden and make office visits more efficient and effective.

Emerging technologies

We can assist in tracking the dissemination, use, and effectiveness of emerging genetic, molecular, and cellular technologies.

The development of targeted diagnostics and treatment is dawning, and we need to anticipate and tract the impact of these technologies on office flow, costs, access, and quality of care in community practices and cancer centers.

Additional services

Qualitative methods (such as focus groups and structured interviewing)

We develop moderator guides and analysis for qualitative methods such as focus groups and structured interviews to ensure that resources will be used effectively. We can also design and manage pilot testing.

The use of these methods has become essential to ensure that new systems meet the needs of users including at the beginning, throughout, and after implementation of new systems. Such changes include modifying the process of care or entirely new delivery programs, software development, and installation of new information systems.

Conference planning and committee work

We have extensive experiences in planning conferences and managing the work of national committees.

Editing and editorial leadership -- both technical and nontechnical

We manage the publication process for books and monographs, including communicating with authors, journals, and editors.