The Role of Academic Medicine in Improving Health Care Quality

Brindis, Ralph G. MD, MPH; Spertus, John MD, MPH

Health Policy

Academic medicine, often entrenched in biomedical and clinical research, has largely ignored the development and application of quality metrics to ensure the delivery of high-quality health care. Nevertheless, academic medicine has substantial opportunities to lead the charge in building a quality infrastructure with the goal of delivering high-quality and cost-efficient health care to all Americans.

The American College of Cardiology (ACC) and American Heart Association (AHA) have worked jointly to measure and improve the quality of cardiovascular care. This effort has led to the development of clinical practice guidelines, performance measures, data standards, national registries, and appropriateness criteria for cardiovascular care. Academic medicine should actively embrace and promote the type of quality metrics and criteria developed by ACC and AHA and apply this model across the entire academic medicine community. Academic medicine, with its many resources, could lead the way in the expanding field of quality science by supporting fundamental research in quality improvement, supporting academicians to improve quality at their own institutions, developing educational models for quality assessment and improvement, creating and implementing data registries, and serving as a conduit for developing the emerging science of quality assessment. In this and many other ways, academic medicine must offer the health care community leadership for improving our nation’s health care quality with the same fervor presently exhibited for the advancement of basic science, the development of specialized and experimental therapy, and as centers for tertiary and quaternary patient care.

Dr. Brindis is senior advisor for cardiovascular disease for Northern California Kaiser Permanente, Oakland, California; clinical professor of medicine, University of California, San Francisco, School of Medicine, San Francisco, California; the chief medical officer and chairman of the American College of Cardiology’s National Cardiovascular Registry, and a member of the Board of Trustees, American College of Cardiology, Bethesda, Maryland.

Dr. Spertus is director of CV Education and Outcomes Research, Mid America Heart Institute, and professor of medicine, University of Missouri—Kansas City School of Medicine, Kansas City, Missouri.

Correspondence should be addressed to Dr. Brindis, Oakland Medical Center, 280 West MacArthur Boulevard, Oakland, CA 94611; telephone: (510) 752-7109; fax: (510) 752-7456; e-mail: (

© 2006 Association of American Medical Colleges