I'm shamelessly plugging this article from Fierce Healthcare's Hospital Impact.
Lynn McVey serves as chief operating officer of Meadowlands Hospital Medical Center, an acute care, 230-bed hospital in New Jersey.
Time to look at the bigger picture on patient safety (September 17th, 2015)
by Lynn McVey When it comes to patient safety, we are still practicing “disease”-care instead of “health”-care. One of my favorite times of year is when new annual healthcare data is released. If you’re a data junkie like me, you’ve probably already read Measuring the Quality of Healthcare in the U.S., which the Kaiser Family Foundation produces each year. This year, Kaiser celebrates that the quality of the U.S. health system is improving in many areas. However, when data junkies like me review data, my spider senses start tingling and my skepticism forces me to drill deeper.
At the top of the data pile is overall mortality rate. In 1990, 1,075 patients died per 100,000. In 2013, only 835 patients died per 100,000, which appears to be an improvement. Unfortunately, if we drill deeper, we see self-reported health status data. In 1996, 15 percent of patients report fair/poor health status, whereas in 2013, that increased to 18 percent. Before we celebrate that we keep patients alive longer, we need to ask if a longer life with poor health should be a celebration.
In all health-related quality-of-life data, we see the data worsening from 1996 to 2013. This includes physically healthy days, mentally healthy days and physical activities prevented due to poor health. I feel this data begs us to keep the end-of-life discussion in the forefront of healthcare reform.
U.S data may be improving in many categories, but when we broaden our data dive, we see comparable countries continuing to outperform the United States on key measures. The U.S. data worsens in the patient safety categories. Compared to similar countries, patient safety is worse in the U.S.
Our data shows no improvement in retaining surgical items/devices post-operatively, which boggles my mind. Do we really have surgeons suturing their patients before the simple act of counting the items/devices? We already unnecessarily harm patients by ignoring Dr. Ignaz Semmelweiss who, in 1847, discovered that hand washing reduced infection. It wasn’t until 1975 when formal written guidelines were published by Centers for Disease Control and Prevention. We seem to have a history of dismissing proven patient safety practices.
Concerning medication, medical or lab errors, we are 6 percent worse than comparable countries. In addition, our post-operative outcomes demonstrate that the U.S. performs worse than its neighbors. Lastly, the U.S. has more post-op pulmonary emboli, sepsis and wound dehiscence than other countries.
Measuring the Quality of Healthcare in the U.S. explains that good data exists on how much money is spent on healthcare in the United States, but much less is known about the correlation between spending and outcomes, and about how much outcomes are influenced by the healthcare system itself. The report also discusses why existing indicators are imperfect, and outlines the challenges of establishing meaningful national quality measures that can reliably show how the system is influencing the health of Americans.
What we know for sure is that of 198 countries, the U.S. is the No. 1 spender on healthcare, yet our outcomes place us at 65th. Like I said before, we deliver disease-care, not healthcare. Much has to be done to repair our unsafe hospitals. Based on my 30-year career, it’s impossible for me to envision a non-healthcare person, say a mechanic, to be taken to an emergency department with severe abdominal pain that needs surgery, plus in-patient care, to be safely discharged several days later without at least one error. I’ve seen hundreds of errors in my own career. When my own father was a patient in my hospital, I prevented two errors because I was in his room.
I had the opportunity to play undercover boss when I spent seven nights in our ICU with my dad. My February 2014 blog describes the total lack of care coordination I witnessed. There is no better lesson than experience. I ask every CEO to spend a night in their ICU. Get the true insider’s perspective. Only then will you be able to improve it.