HHS Strategic Goals and Objectives - FY 2001 . Goal 4 - Improve the Quality of Health Care and Human Services


Improving quality of life and health in the United States also involves improving the quality of human services and health care that persons receive. The focus of this goal and supporting objectives is on the implementation of a variety of strategies to improve service quality. In this respect, several of the objectives parallel the goals in the Department's health care quality initiative. (Other elements of the initiative are included elsewhere in the strategic plan.) On the human services side, quality improvement focuses on the generation of knowledge that can be translated into the improvement of human services.

While many Americans receive quality health care, there is disturbing evidence that quality is a problem in a number of areas. The Institute of Medicine of the National Academy of Sciences estimates that as many as 98,000 persons die each year from medical errors (To Err is Human: Building a Safer Health System. National Academy Press. Linda T. Kohn, Janet M. Corrigan and Molla S. Donaldson, editors. 2000). Under-use of services is an ongoing challenge. For example, one study found that 30 percent of women age 52 to 69 in surveyed managed care plans had not received a mammogram in the previous two years. On the other hand, some services are used unnecessarily. One study indicated that half of all patients diagnosed with a cold and two-thirds of the patients diagnosed with acute bronchitis received antibiotics which offer little or no benefit for these conditions. Screening tests are sometimes misread. One study found that anywhere from 10 to 30 percent of Pap smear test results were incorrectly classified as normal. Finally, improving health care quality must involve consumers and purchasers of health care who are knowledgeable about quality choices. Yet when considering and selecting their health care options, the majority of Americans do not use quality-related information comparing the quality of health care plans, doctors, or hospitals to make their choices.

With respect to the quality of human services, the Department has been engaged in the development of a research strategy to better understand the transformations in human services programs. This strategy identifies the requisite knowledge base, data, performance measures, and program evaluations and research needs for national leadership. The movement toward devolution of responsibility for human services to state and local organizations and the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 offer tremendous opportunities and unprecedented challenges in the redefinition and implementation of services to families. Documenting, understanding, interpreting, and facilitating the exchange of information and experiences among states is essential for encouraging sound decisions that promote the well-being of families and children.