A national campaign will soon be underway, aimed to help Americans to better manage pain by working with their healthcare providers. The Joint Commission's "Speak Up" campaign will essentially help patients to become more informed about their healthcare and more involved in decisions concerning it.
Although a state law requiring that hospital-acquired infection rates be made public went into effect two years ago, the New Hampshire Health and Human Services department is still requesting additional time to do so. They promise, however, that the information will be published publicly by next year.
The Centers for Medicare and Medicaid Services will stop paying for costs related to treatment of hospital-acquired infections starting next month, as experts say more than 100,000 people die each year from infections, including MRSA, contracted during a hospital stay. Hospitals nationwide will also soon be required to disclose their infection rates beginning next year.
A recent study found that many large medical groups lack key elements needed to develop patient-centered "medical homes," such as electronic medical records. But the largest medical groups and those owned by a hospital HMO scored highest on the four critical areas of a medical home model. The study suggests that could be because they have more resources to invest.
As the fall of financial giants Lehman Brothers and Merrill Lynch hit the news earlier this week, some of you breathed a giant sigh and said, "Thank God I work in healthcare."
Healthcare is infallible, right? Regardless of how bad the economy is, people will always need healthcare. People get sick no matter how much or how little money they have in their bank accounts. And we've all heard about how sick the baby boomers are and how much they'll need our hospital systems in the coming years. It's the safest industry out there—economically speaking.
Well, yes, and no. Healthcare organizations that are managed well, always strive for quality, and provide patients with a positive experience probably won't have to worry about their business drying up. But those whose focus is off will have to answer to more demanding consumers who want to stretch their dollars as far as they can.
This week I attended the National Association for Healthcare Quality's Annual Education Conference in Phoenix, and I found it slightly ironic that as stocks were tumbling Monday, I was sitting in on a session that talked about the collapse of American business and what it can teach us about healthcare quality. It was presented by Kristine Tomzik, RN, MSN, MBA, chief compliance officer for UCERA, an organization that supports research at the University of Hawaii Medical School. Tomzik based her presentation on the book, "The Seven Signs of Ethical Collapse" by Arizona State University business professor Marianne Jennings.
Like it or not, healthcare is a business, and hospitals face the same possibility of collapse that we've seen in America's financial institutions, Tomzik said. The difference, though, is that in healthcare there is more than money at stake. The harming of a patient can instantly change the fate of an otherwise successful healthcare organization.
But no human is perfect and all healthcare organizations face the possibility of a fatal medical error—today, tomorrow, or next week. That's why you must make sure your business is a strong one long before that error happens. That's where Jennings' list comes in.
1. Pressure to maintain numbers. At most of America's businesses, these numbers are financial, but in hospitals, it's usually outcomes that are the source of pressure. The effort to maintain them often prevents those working in the industry from looking at the bigger picture—including new solutions that will bring better outcomes.
2. Fear and silence. Employees aren't encouraged to speak up when there's a problem. When they do they are met with resistance from managers—or worse, indifference. Problems continue, creating a work force that is apt to become distracted by fear, silence, and frustration.
3. Bigger than life CEOs. Are you, or a member of your executive team constantly talking publicly about how great things are at your organization, when you're hardly there to see what's going on? Do you trust other executives to tell you what's going on in your hospital departments instead of getting out there and seeing for yourself? I've heard a lot of NAHQ attendees grumbling this week about how their CEOs don't know what's really going on at their organizations. Successful CEOs are tuned in to their organization—both the good and bad—and know when to admit there's a problem.
4. Weak boards. When quality data are presented to your organization's board of directors, how does it respond? Is the data presentation the last item on a packed agenda, greeted by glances at the clock and lazy yawns? Or does the board actively discuss the information presented to them, asking questions about outcomes and processes? Do board members suggest ideas for improvement? A strong organization's board must concern itself with not only financial matters—but those of quality as well.
5. Conflicts. How many times have you seen quality improvement initiatives derailed by a disagreement between individuals or teams of individuals? A leader of a strong organization will know how to work with those who have their own agendas and get by obstacles to provide patients with the best care.
6. Innovations like no other. Beware of those "brilliant" ideas that bend the rules slightly or go against what your organization stands for. A perfect example of this is Richard Scrushy, founder of HealthSouth, a system of outpatient rehabilitation facilities based in Birmingham, AL. HealthSouth appeared to be an incredibly successful system in the 1990s, growing at rates that most healthcare organizations only dream of. But after the organization's demise earlier this decade, it was discovered that Scrushy used his own methods of accounting to make system's numbers look better than they actually were.
7. Goodness in some areas atones the evil in others. If your hospital is transferring uninsured patients to another across town, but bragging about the money it donates to the free clinic up the street, you may have a problem. No amount of external contributions to the community, Tomzik says, can make amends for serious improprieties and schemes.
Leaders who have primed their organizations for success—regardless of economic conditions—won't recognize these problems in their organizations. Keeping your business healthy means paying attention to quality at every turn—from patient care to philanthropy—and never wavering in the mission to offer the best possible care.
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Vanderbilt University Medical Center will replace Saint Thomas Health Services as the official healthcare provider for the Nashville Predators hockey team. The multi-year partnership is the first such sponsorship deal for Vanderbilt University Medical Center.
Children's Hospital Boston has received a $150,000 donation from the Jeffrey Modell Foundation and Talecris Biotherapeutics Inc. The funding will expand clinical care and outreach for children with primary immunodeficiency. According to officials, the donation will also create more opportunities for advanced research.
Many in healthcare continue searching for ways to tie payments to high-quality care, while reducing costs. A recently published essay in the New England Journal of Medicine outlines several ways to do this, including episode-based payments and "the medical home."
Doctors are sometimes accused of malpractice, whether they've done something wrong or not. There is an expectation in cases where a patient does poorly that the doctor should have done more. However, sometimes things gone wrong no matter what you do.
Bayer HealthCare AG has acquired DIREVO Biotech AG, a German biotech company, strengthening its "research competence" in biologicals in the pharmaceutical division of Bayer Schering Pharma. The deal is expected to be closed by the end of the month.
