You have a right to know how will hurt and who will heal…
Posted by steven_spear | Under Innovation, health care, high velocity organizations Thursday Aug 13, 2009Gawande, Berwick, Fisher, and McCellen (”10 Steps to Better Health Care,” NYTimes, August 13, 2009) document what many of us already felt: For the same service some health care organizations deliver great care affordably while others provide compromised care that is still costly. If we all got care from the best, they suggest, there would be no crisis.
The irrefutable conclusion is that with such range in quality and cost, you have a right to know who will help you and who will cause you harm. In service to that right, the necessary policy is clear: Mandatory reporting–first of avoidable complications like medication error and falls, building to ever better measures about efficiency and effectiveness. With reliable information, you can choose wisely, and every informed choice will raise quality, reduce cost, and keep bureaucrats from having to make our decisions for us.
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Steve, absolutely agree! Public reporting is essential for accountability, learning, and improvement and the public is critical in this loop. We have a non-profit in Mass, the Partnership for Healthcare Excellence, that has advancing the public understanding of variation as one of its three primary goals. Drawn from the field of high reliability, a tenet at the Institute for Healthcare Improvement (IHI) is that safety is impossible without transparency.
One of the challenges that remains in patient safety is the effectiveness of error case finding systems. Studies show dramatic underreporting in conventional approaches such as “if you see something, say something.” While important, organizations must become more expert “in looking for trouble” by adding in trigger tools or other systematic approaches. Then they can report the serious events they find. With that approach all of us, including the public, have the reliable information we need to inform learning as well as to drive accountability and improvement.
Thanks for the informative blog, Jim
Jim Conway
SVP, IHI