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Survey Finds Providers in Agreement on Need for Better Health Care

Kate Traynor

A national survey of over 1000 health care professionals adds weight to the belief that Americans are not receiving the quality of health care that they should.

Ninety-five percent of the physicians who responded to the survey claimed to have witnessed at least one "serious" medical error, as had 89% of the nurses and 82% of the health care executives. Thirteen percent of the respondents described errors as an "almost routine" part of today’s health care system. Nearly three quarters said America’s health care system needs "fundamental changes," and 11% said the system should be scrapped and rebuilt.

Results of the survey, which was commissioned by the Robert Wood Johnson Foundation and conducted in March and April by Wirthlin Worldwide, were released in May. Among those interviewed for the survey were 600 physicians, 200 administrators, and 200 registered nurses.

How good is good? Health care quality, defined as care that is "safe, effective, patient-centered, timely, efficient, and equitable," was deemed "very good" or "excellent" by 42% of the survey respondents. Twenty percent of the interviewees rated U.S. health care quality as "fair" or "poor."

When asked how difficult improving health care will be, about 90% of those surveyed chose the middle ground, saying that quality-improvement challenges are neither "insurmountable" nor "easily solved."

Professional responsibility. Over three quarters of the respondents said that organizations such as hospitals, health maintenance organizations, and physicians’ groups should take the lead in improving health care quality. Nearly half wanted professional associations and individual practitioners to be at the forefront of change.

Sixteen percent of the professionals surveyed doubted that their personal efforts could do much to improve the quality of health care. But 57% said they could have a "substantial impact" on or personally lead the drive toward high-quality health care.

Perfection: The $21-million question. Forty-five percent of the survey respondents said health care performance should be close to error free. To help meet this goal, the Robert Wood Johnson Foundation has pledged nearly $21 million for grants and technical assistance projects aimed at producing an error-free health system. The improvement program, which is administered through the Boston-based Institute for Healthcare Improvement (IHI), is called "Pursuing Perfection: Raising the Bar for Health Care Performance."

According to IHI, the organization had already received 226 grant applications by May 8, the day the program was formally launched. IHI announced that up to 12 $50,000, seven-month grants will be funded; 6 of the grants will be expanded into projects of $1.5 million to $3 million. Information about Pursuing Perfection is available at