In the quest for quality care, business as usual won't do. Progress is what change is all about. And there's an upside: When value-based payments really hit, evidence-based medicine may get some traction.
"As we contemplate its contentious present and problematic future, we remain prisoners of its past." —Charles E. Rosenberg.
Change rarely comes easily. Hospitals are currently coping with major shifts in payment models, patient care, technology, and more. These changes are designed to improve the quality of care, but not all them are going well.
Lately, we've see revolts against meaningful use and excessive quality measurement. In addition, data is piling up on the failure of doctors and hospitals to deliver evidence-based care.
So, here's some blunt advice for the hospital industry: Change is constant. Deal with it.
Lee Penrose is the CEO of St. Jude Medical Center, a 351-bed Fullerton, California hospital which is part of the St. Joseph Hoag Health system. "In order to embrace a new future, we have to be more comfortable with change," he says.
"We have to be ready to experience our work in a different way. In this consumer-driven industry, were either going to change or we are going to be eaten up."
Still, Penrose, a 20-year industry veteran, says that hospitals are currently dealing with an unprecedented level of change. On his plate: a merger between St. Joseph Hoag Health and Providence Health & Services, a system with 34 hospitals in five states.
Old Days, Old Ways
One way to understand the need for change is to look at what some might call the good old days. In the pre-DRG era, doctors ordered whatever care they saw fit, no one questioned it and insurance covered it.
Patients paid little; they were either too poor or too insured. With no consumer pressure, costs ballooned. Patient experience? Patient stays were longer, the food was horrible, and there was no cable TV. All the doctors were men, all the nurses were women, and all the bosses were white.
Patient safety and infection control measures were not what they should be. And, orders were scrawled on note pads, recorded on paper, and transmitted via courier or fax.
No one wants to go back there. But, with change, it is good to keep in mind that sometimes things get worse before they get better. Take the implementation of electronic medical records.
Tinker Ready is a contributing writer at HealthLeaders Media.