Weekly Article: Every mom makes the world’s best spaghetti sauce

By Paul Mullan 

David Sklar is an emergency medicine physician, a quality improvement (QI) advocate, and the current editor-in-chief of Academic Medicine (the AAMC journal). In this month’s Academic Medicine, he wrote an editorial (Acad Med, 88(2):147-8) calling for academic health centers to improve the quality of health care delivery:  Quality and Spaghetti Sauce.

Just as there is no perfect spaghetti sauce for everyone (the results are more tri-modal, between plain, spicy, and chunky), he argues that we should not assume that we always know what’s best for individual patients in certain clinical circumstances.    

He describes five ways in which academic health centers are uniquely positioned to address the national goals in QI and some suggestions/questions for each:

1. Develop quality measures. Measures exist but few physicians report on them  - do we have the wrong measures? What could make the reporting system easier?
2. Educate learners (didactic and hands-on) at all levels (medical students, residents, faculty, physician extenders) in QI science.  This will require time and financial investments at all levels but the multiplier effects downstream could be enormous.
3. Engage in QI science and methodology at clinical facilities.  Break down silos between researchers and clinicians.
4. Engage with patients in defining patient-centered quality in health care.
5. Become models of high-quality health care delivery. He argues for adding QI as a scholarship tracks to the other tracks of education, research, and clinical care.

It will be exciting to see what we can learn from Children’s National events such as the “I Have the Power: Patient Experience Day” (this Thursday from 4am-6pm) and other similar programs.
Also, on a personal note, I need to pick a primary care doctor for my HMO – initially I had picked one close to our house for convenience sake… then I got the Northern Virginia magazine (not peer-reviewed…) “top” doctors edition.  One can quickly understand how some patients, myself included, can come down with an acute case of analysis paralysis trying to figure out which health care provider’s spaghetti sauce will suit their palate best.