How Much Should We Measure in Hospital Quality?

Why some of the leading pundits have it all wrong

OMW! Here we go again. Yesterday in an editorial on psqh.com, Don Berwick is quoted as stating at the IHI National Forum in December 2015, that we should “cut in half all metrics currently being used and then cut them in half again.”

I wholeheartedly disagree. And here is why.

Clinical Dashboard – Hemorrhagic Stroke

Ischemic Stroke DB Pt 1

How to Solve Our Healthcare Patient Safety Crisis

And a New Resource That Can Help

We have a healthcare crisis of epic proportions – a patient safety crisis. It only came to light in the 1990’s, but its likely existed in all of our healthcare organizations for our entire careers. But so far, we have only made a dent in the problem. Our patients know this and they are afraid, their families are afraid, and when we’re honest with ourselves, many of us worry about being hospitalized in our own organizations.

Here are the sobering statistics:

  • 210,000 to 440,000 people lose their lives each year to medical errors in hospitals, according to research conducted by J. James and published in the Journal of Patient Safety.
  • Medical errors may now rank as the third leading cause of death in the United States; only cardiovascular disease and cancer takes more lives each year.
  • Preventable Adverse Events (PAEs) account for “roughly one-sixth of all deaths that occur in the U.S. each year.
  • More than 1,000 people die every day from preventable accidents in hospitals.
  • Preventable medical errors, in the form of “oops”, errors of omission, complications, readmissions, and avoidable mortality cost the US economy untold billions each year.
  • The average hospitalized patient experiences 1.5 medication errors daily and medication errors are the most common form of error.
  • There are more than 6 million patient injuries per year due to errors.
  • 40 percent of hospitals received a C, D, or F on Leapfrog’s Safety Score.
  • According to the Leapfrog Group, “since Fall 2014, (hospital) performance on safety outcomes – including preventing errors, accidents, and infections – has not significantly improved.”

Surgeon Complication Rates Now Posted on the Internet

Information on Physician Performance is Here to Stay

Patient complication rates have been posted on the Internet for almost 17,000 surgeons. This landmark undertaking was achieved by ProPublica, an independent, non-profit newsroom[1].

ProPublica posted their “Surgeon Scorecard” in July. It compares the performance of surgeons for eight common elective procedures, including hip and knee replacements, spinal fusions, gallbladder removals, prostate resections, prostate removals, and cervical fusions.

The power of ProPublica’s site was demonstrated to me this morning when my brother sent me a text message that said, “Kathy (his wife) is having her knee replacement this morning.” I immediately asked for the surgeon’s name and then looked up his stats on ProPublica’s new site. In less than 5 minutes, I had information that would have previously taken hours, if not days, of phone calls to colleagues and professional acquaintances for recommendations and best guesses about who would be best for my sister-in-law to see.

The Top 10 CEO Roles in Quality – Part 2

In my first post on this topic, I covered the first THREE Critical Roles for CEOs in your organizations.

We reviewed that some CEOs have embraced the quality agenda and gladly lead the charge.  They lead high performing organizations that are often listed in the Top 100 hospitals and the Healthgrades Distinguished Hospital lists.  But in organizations where the CEO is silent, quality performance can be mediocre or worse.  A CEO who is active and involved is one of the keys to a top performing organization.  And because better quality = lower costs, they often lead the most cost effective organizations as well.

Here are the next three CRITICAL ROLES for your CEO:

The Top 10 CEO Roles in Quality – Part 1

Effective quality and safety programs take effort, resources, and unrelenting determination.  They also require leadership from all levels of the organization.  But leadership from the top is critical. As Harry Truman said, “the buck stops here”.  In this case, it “begins and ends at the CEO’s desk”.

Many CEOs have embraced the quality agenda and gladly lead the charge.  They lead high performing organizations that are often listed in the Top 100 hospitals and the Healthgrades Distinguished Hospital lists.  But in organizations where the CEO is silent, quality performance is usually mediocre at best.  A strong, vocal CEO is one of the keys to a top performing organization.  And because better quality = lower costs, they often lead the most cost effective organizations as well.

So, what do these CEOs do that distinguishes them and their organizations?  Here are three key roles that the CEO can play that will propel your organization toward best in class quality and cost effectiveness.