Friday, March 7, 2014

Transparency…Does it Matter in Healthcare?

One of the reasons why people say that market forces don’t work in healthcare is because the consumer (patient) has poor access to data to judge the quality of the product. GBMC HealthCare has now had many of its quality data publicly available and updated monthly for over a year. Are people coming to our website www.gbmc.org/quality before they choose where to go for care? It is very hard to tell.

Our data show that we have made excellent progress in many areas. Hand hygiene is significantly improved over just a few years ago. Perhaps because of this and the hard work of our nurses, physicians, and other clinicians, our rates of hospital acquired infections- catheter associated urinary tract infections in particular, have decreased significantly as well. We have now gone seven months without a hospital acquired pressure ulcer. Do our patients care? Why have other local hospitals not followed us in making their data public? Do they know something that we don’t?

U.S. News and World Report continues to name “Best Hospitals” that the national data reporting system shows frequently as having average performances (see www.medicare.gov/hospitalcompare/search.html). The last round of awards did begin to generate some conversation among academics about the illogical nature of these awards but the public didn't seem to care. It appears that healthcare organizations keep their “brand” strong or otherwise independent of the evidence.

I believe however that the public is beginning to wake up and so called value-based healthcare will start to get some traction. We can no longer afford the 40% waste in the U.S. system. Please discuss this with your friends. Do you have ideas for helping patients make decisions about healthcare? Please share them.

5 comments:

  1. I know we give excellent care at GBMC. Any time I tell someone where I work, the response is, "I love that hospital!" So when we get "dinged" on the Press-Ganey/HCAHPS survey for things out of our control, like "the room was too small" or "they forgot the butter for my toast," it negates what really matters: The quality of CARE. It's like someone going to Johns Hopkins and complaining about the neighborhood around it. Our surveys should focus on how well we took care of our patients, and if we made sure they left in better shape then when they arrived!

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  2. Thanks, Anonymous.

    I read the Patient Satisfaction comments and it is very rare that someone complains about the room size. Even when they do, they usually give us very high marks. Our vendor, Press Ganey, calculates the things most likely to make our overall HCAHPS score go up if we work on them. As of today, the top three questions we need to work on are: 1. During this hospital stay, how often did staff listen carefully to you?; 2.During this hospital stay, how often did staff treat you with courtesy and respect? and 3. Before giving you any new medicine, how often did hospital staff describe possible side effects in a way you could understand? The only question that is not actually about care that frequently makes it to the top 5 or things to work on is room cleanliness. This is why we are now training our housekeepers on standard cleaning work in our sim lab and making sure that we have enough housekeepers to clean all rooms daily. If you are a care-giver, you may want to ask your manager to review what the priorities are on your specific unit.

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  3. I think we are very lucky to have the wonderful reputation that GBMC has but I agree that we can not sit back on our "laurels" and expect that reputation to support us as we enter the new frontier of healthcare awareness, healthcare cost, and healthcare transparency. I look at my healthcare options much differently than my parents did and my grown children have an even better "level of expectation" regarding healthcare. I believe the honest and ernest transparent approach GBMC is currently following will support our system, and our goal to treat evey patient, everytime, as we would want our own loved one to be treated. That is what I want, what my children want, what everyone wants when they have to deal with medicine and hospitals. Showing that GBMC is continually working to provide that type of service and care can only be good for the future of this organization and the people we care for.

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  4. Call it old fashion, or out dated philosophy... what remains true is people want to feel they belong among us, and that He/She matters. This feeling exist in all language, culture, profession, and region. I think it speaks volume when we see people as human being 1st. In doing so, in my opinion you forcast genuine impress "person to person" and that creates positive vibe. Maya Angelou illuminates this thought better "They may forget your name (GBMC, Johns Hopkins, St. Joesph, RN , NST, and so on), but they will never forget how you made them feel". To impliment one idea would be for all who enter at GBMC for patient care lets make them feel that they matter as a human being 1st. And doing so... provide the best patient care medicine can offer.

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