Posted by: qmaxim | September 27, 2012

How to Stop Hospitals From Killing Us

Recently, I read an article titled “How to Stop Hospitals From Killing Us”. It is about alarmingly high rate of medical errors in the USA and how it can be reduced. According to this article, medical mistakes kill enough people each week to fill four jumbo jets. 25% of the hospitalized patients are harmed by medical errors.

Why this article caught my eye?
Not because of the alarming figures which indeed these are. Generally, health care quality related articles are written by Quality experts, but this one is by Dr. Makary, a practising surgeon of a highly reputed hospital. Most such articles are  about use of Lean Six Sigma & / or Malcolm Baldridge Quality model for making things better. Many conferences are held on such topics yearly. In fact, American society for quality (ASQ) has separate subgroups dedicated to quality in health care field. Medical errors can affect everyone, hence it is important to know.

He suggests 5 relatively simple reforms to bring the rates down dramatically.

1. Online Dashboards- publish hospital’s performance online. Dashboards should cover things such as surgical procedures’ rates for infection, readmission, surgical complications and errors which should never occur. Publishing results have lead to considerable improvements in performance of hospitals. For the patients checking up the performance results  before getting admitted will be highly beneficial too.

2. Team culture- there is a direct correlation between teamwork (between doctors, nurses and support staff) and infection rates and patient outcomes. Improving team culture can help a great deal.

3. Cameras: videotaping the work of surgeons can lead significant improvement in quality of work. Sharing it with patients can be  even more beneficial.

4. Open notes: Quite often there is a mismatch between what the patient tells the doctor and what he hears and records. Verifying the accuracy of notes taken by the doctor with the patient can lead to improvement in accuracy of medical records.

5. No gagging: Increasingly, patients are required to sign a gag order not to talk ill of the doctor or the hospital to anyone or online. Stopping this practice can lead to regaining public’s trust about doctors which has been falling over the years.

All these steps are nothing but application of basic principles of quality and improving communication. None of them involve usage of high technology, sophisticated data analysis or methodologies such as Lean Six Sigma. Getting the basics right to begin with can lead to remarkable improvement in the results.

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