Throughout my career in healthcare quality improvement and patient safety, I have worked with people committed to making care safer, more effective, and more responsive to patients and families. I have also seen how difficult it can be for the public to find and understand information about the quality of that care.
Over the past two decades and more, healthcare professionals, patients, families, and organizations have helped advance important improvements. Before surgery, practices such as confirming the patient and procedure, marking the procedure site when appropriate, and pausing for a team “time-out” provide safeguards against devastating errors. Surgical safety checklists help teams communicate and consistently address critical steps in care. These practices are important advances, although their effectiveness depends on how reliably teams use them. [1] [2]
There has also been measurable progress in reducing harm. For example, the Agency for Healthcare Research and Quality reported a 13% reduction in measured hospital-acquired conditions between 2014 and 2017. That finding documents improvement during a specific period; it does not mean every hospital improved equally or that progress is assured. [3]
More recently, the Centers for Medicare & Medicaid Services introduced the Patient Safety Structural Measure. It asks hospitals to report whether they have essential foundations for safety, including leadership commitment, a culture of learning, accountability and transparency, and meaningful patient and family engagement. It recognizes that safety depends on how an organization operates—not simply on individual vigilance. The measure assesses reported structures and practices rather than directly measuring patient outcomes. [4]
These advances matter. Yet preventable harm continues, and no single rating, award, checklist, or accreditation provides a complete picture of care.
I created Choosing Quality Care to help bridge the distance between publicly available information and the people who could benefit from it. Government agencies and private organizations publish useful reports, but finding them, understanding their differences, and deciding what to ask next can be challenging.
This guide brings credible sources together, explains their limitations, and helps you prepare questions about the care you need. It does not rank facilities, identify one “best” choice, or replace conversations with healthcare professionals.
Patients and families should be welcomed as partners in care. They should not be expected to become quality experts or carry responsibility for preventing failures in healthcare systems. That responsibility remains with the organizations and professionals providing care.
My hope is that Choosing Quality Care helps you approach those conversations with clearer information, thoughtful questions, and greater confidence that your concerns deserve to be heard.
Stephen L. Davidow, MBA-HCM, LSSBB, CPHQ
Founder, Choosing Quality Care