Invited commentary: Baylor Health Care System: sharing the vision of the quality challenge

What a delight to read Carolyn Clancy's “Conversation with the editor.” The director of the Agency for Healthcare Research and Quality (AHRQ) could reasonably be anticipated to be another ogre of bureaucracy. Not at all: she enthusiastically epitomizes best care, quality medicine, and raising the bar, challenging each one of us to do better for our patients and practice more efficient medicine—and prove it. She is excited by this challenge and looks forward to the day when we all work together as an effective team providing the best care to our patients. In many areas of medicine, we have the evidence for best practices and yet we fall short on performance. How do we create the mindset that there is a right way and that we should conform to the standards and data that exist? In the Baylor Health Care System (BHCS), Dr. David Ballard leads the Institute for Health Care Research and Improvement and has been able to provide institutional and physician data to measure against benchmarks of quality. This very powerful tool in changing physician behavior has been a major factor in helping Baylor maintain its premier quality image in the marketplace. Our achievements are based on hard data, the result of enthusiastic medical staff, administrators, and allied health professionals striving to provide the best care and proving it! BHCS embraced the Institute for Healthcare Improvement's 100,000 Lives Campaign and has put in place the core measures recommended. Carolyn Clancy, AHRQ, and BHCS are all aligned not only to provide the best care at the right time, but also to address health care quality disparities—disparities based on race, ethnicity, and income. Baylor's commitment to the community cannot be questioned. In the USA today, the gap between high-quality care and low-quality care is wide. Dr. Robert Mayberry addresses this national challenge in this issue of Proceedings. Baylor has a founding statement that people “of all creeds and those of none” will be taken care of with the highest quality of health care that Baylor can provide. The goal that Carolyn Clancy subscribes to is that of transforming solid, evidence-based medicine into everyday clinical practice. Health information technology is a key element in achieving these goals of quality improvement. Effectiveness research is a foundation for improving quality. Perhaps the most important factor in quality medicine is professional pride, and this is the strongest attribute that Baylor professionals provide to the system. Carolyn Clancy, AHRQ, and BHCS—from the boards to the volunteers—share the vision of the quality challenge, and together we will make it happen. This edition of Proceedings focuses on quality outcomes with contributions from Herrin and his coauthors on interventions to improve care for diabetic patients. Clancy very astutely assessed the role and place of research in the Baylor Health Care System: “BHCS has … [an] unusual relationship between its scientific research center and its entire clinical enterprise… . ” The senior leadership team has made a commitment to support clinically relevant research that enhances our clinical programs, patient safety, and quality of care. This is a tremendous investment in the future of BHCS but also the future of medicine locally, nationally, and internationally.