Excellence is a necessity, not a luxury.

THE CENTRAL THEME in both feature articles in this issue is the need to embrace measurements in the healthcare industry. This supports not only my personal belief as a physician and healthcare leader but also the philosophy of the entire CHRISTUS Health system: if you cannot measure it, you should not do it. We believe that if you cannot measure it, you will never know if you achieved your goal, you cannot hold anyone accountable for the task, and you will not be energized by knowing that you did, in fact, cross the finish line. Healthcare is complex, so the energy received from celebrating the incremental victories is essential to continue on a journey to excellence. THE IMPORTANCE OF SUPPORTING QUALITY MEASUREMENT Although the multiple reasons for supporting measurements of quality of care are well articulated in both articles, the primary reason for supporting measurements must be that excellence in healthcare can only be achieved if benchmark, best-practice processes are implemented and if benchmark, evidence-based outcomes are achieved. Ultimately, healthcare leaders must firmly embrace the belief that-for all patients and families who enter our doors-excellence is not a luxury, but a necessity. This commitment to measurement, which is a major driver to excellence, will be constant and complete if we always remember that the millions of people who enter the doors of our clinics, hospitals, and outpatient procedure centers each day in the United States trust us, the healthcare providers, enough to surrender their lives or the lives of their loved ones to us. What an awesome responsibility we have! Measuring our quality outcomes is the only way to fulfill this responsibility and to prove that their trust in us is justified. It is clear, somewhat contrary to the statement in the summary of the article by Patrice Spath, that the value of performance data is not in question. What is in question is the value of outdated data, inconsistent data, and inaccessible data, all of which are clearly illustrated, referenced, and discussed. If all physicians, nurses, and other healthcare providers were completely honest, they would admit that using evidence-based treatment protocols is the best way to ensure that a positive outcome will be achieved for each and every patient. All clinicians know that the best outcomes are achieved when consistency is applied to the care process. They also know that care processes depend on the review of accurate diagnostic data, including radiology and laboratory results. And finally, they know that the best way to achieve consistently excellent outcomes is to constantly compare their outcomes to those of their peers. Is not the common thread in all three of these truths the recognition that success in achieving excellent clinical outcomes depends on the intense collection and reviews of measurements? QUALITY MUST REMAIN AN ESSENTIAL GOAL Although both articles appropriately describe many present-day barriers to achieving quality through measurement, the program Ron Anderson, Ruben Amarasingham, and S. Sue Pickens describe at Parkland Health & Hospital System clearly delineates what can be accomplished if the quest for quality becomes an institutional imperative. With such an imperative embraced as an "essential" and not a "luxury," the barriers, if not eradicated, are minimized to a level that they are surmountable. More consistency and standardization replace no consistency. Regular collection of data replaces spotty reporting. Voluntary transparency replaces mandatory reporting. Two-year-old data as reported on governmental Web pages are replaced with current data on the health system's Web page. Mandatory collection of data is supported while computer-based programs are being created, and consumer-friendly methodology of data access and interpretation replace cumbersome governmental sites, which often deter high utilization. EXCELLENCE IN ALL AREAS IS NECESSARY AND ATTAINABLE Although it is obvious that these articles deal first and foremost with the issue of clinical quality measurement and implementation, one of the tenets strongly held by CHRISTUS leadership is that improvement in an organization must take place on several fronts at once. …