But take a look anyway, if you have an interest in process improvement in hospitals. This is a collection of my best posts on this topic.

Tuesday, May 18, 2010

Timidity in Massachusetts

Over three years ago, while posting our rate of central infections, I asked the following questions:

If I can post these rates for BIDMC, why can't people from other hospitals? ... Why can't the insurance companies? ... Why can't the state of Massachusetts? ... Real-time public disclosure of key indicators like this ... can be mutually instructive and can help provide an incentive to all of us to do better.

Well, Massachusetts is getting passed by on this front. Here is a presentation showing the rate of central line infections for all of the hospitals in Illinois for 2009. If you sort on the column "infections per 1,000 central line days" by clicking on that header, you will find 50 hospitals with zero infections, and 31 more with fewer than one per 1,000.

This kind of presentation does not require state action. The Massachusetts hospitals could together decide to do this voluntarily. We all collect the data for our own hospitals. It would impose no administrative burden to forward it for publication to a collective website. (Look here to see BIDMC's figure, posted every quarter.)

What more persuasive way to demonstrate to the public and to legislators that we collectively are serious about eliminating one important form of hospital acquired infection? That we are willing to be held individually and collectively accountable to a standard of care to reduce harm to patients? That we likewise are willing to be held to a standard of care that also saves dollars for an overburdened health care system?

Look at this related story in the Chicago Tribune. An excerpt:

Ten years ago, Dr. Bob Chase would have laughed if someone had told him common infections could be eliminated in hospitals' intensive care units.

"I would have said that's ridiculous, not possible," he said. "As a physician, I was trained to believe bad things just happen."

But Chase, vice president of quality at Norwegian American Hospital in Chicago, doesn't think that anymore. A growing body of research has convinced him that many infections can be prevented if proper procedures are rigorously followed — evidence he's using to reduce higher-than-expected infection rates at his own institution.

The research is prompting a wave of improvements in hospital ICUs, and patients are starting to benefit: At many hospitals, the rates of some common infections have been cut in half or more, saving lives and money and preventing medical complications.

Why are the health care leaders in Massachusetts so timid on this issue?

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