The Globe yesterday ran a story on hospital-acquired infections, noting that the Commonwealth of Massachusetts might require hospitals to report their statistics on this matter. This is a good thing, part of a trend slowly spreading across the country.
It is good for two reasons. First, the public has a right to know about fundamental measures of patient quality and safety in institutions in their communities. Second, as a management tool, there is nothing more effective for hospital administrators than to be able to remind their staffs that actual clinical results will be made public.
But, here is the subtle and very important point. If public reporting devolves into a culture of blame, it will undo all the good that would otherwise be done. Here, reporters and politicians need to be very careful.
The idea is to use data to bring about constructive change and improvement. While some hospital-related infections, injuries, and death are the result of a doctor's mistake, many are the result of systemic problems that take analysis, understanding, and thoughtful problem-solving to fix.
I can also assure you that, when a doctor makes a mistake, he or she already feels more remorse about it than you can imagine. There is no reason to pounce on people who have devoted their lives to helping us.
I believe that many doctors and hospitals do not want to post these data because they have little confidence in the ability and motivation of the press and elected politicians. They fear they will just be punching bags or targets for commercial or political gain.
So, yes, hospitals and doctors face a challenge in overcoming their defensiveness and reluctance to share in this arena -- but the rest of society faces an equally difficult challenge in using the information responsibly.
I have chosen to post BIDMC's data because I believe the only way for us all to learn how to do this well is to actually do it. I continue to hope that my colleagues in the Boston area hospitals will join in and that our journalists and elected officials will provide the kind of positive reinforcement that makes this truly infectious behavior.