The University of Michigan Health System has done exemplary work in improving the quality and safety of patient care. Perhaps the most visible success, as part of a statewide effort, was to eliminate central line infections in ICUs for extended periods of time. But UofM has a broad-based program beyond this, which gets support from the senior leadership and participation throughout the organization.The system is also very open about its clinical outcomes and the status of its process improvement. As noted on this website:
This site shows where we're doing great and where we can perform even better. The site also offers information about quality care, quality measures, and what quality really means to the most important people in our community: you - our patients and families. While quality reports from other sites may be a year old or more, the reports on our website show the most up-to-date measures of quality and safety at the University of Michigan Health System.
People are then invited to explore more deeply. I recently did, but rather than offering my opinions about the site, I thought I would ask you to take a few moments to click through it and offer your views here. Knowing the folks at this system, I am sure they would like to have the benefit of your suggestions and ideas about the content and design of their presentation.
I have little experience viewing such websites, although I am familiar with the Outcomes booklets sent to physicians by the Cleveland Clinic. My impression as a sort-of novice is that this website is clean and clear and easy to understand. They do a good job of explaining process vs. outcome measurements and trying to address risk adjustment and other complexities understandably. In the cancer care section they clearly have a ways to go, selecting only 2 surgery-dominated categories. And I question their statement:
ReplyDelete"...using robotic laparoscope, which improves outcomes. In 2009, 95% were robotic-assisted operations."
The evidence is not at all clear that robotic survery improves outcomes.The fact they moved from <50% robotic surgery to 95% in 5 years is a cause for question, not something to be advertised, as indicated by this recent quote from MedPage Today:
"Adoption of robotic technology fueled rapid growth in the use of prostatectomy at a time when the incidence of prostate cancer decreased, investigators reported here." (Lavery HJ, et al "Not a zero-sum game: The widespread adoption of robotics has increased prostatectomy utilization in the United States" AUA 2011; Abstract 76.)
The take-home point is that a website like this needs to be careful not to veer from transparent reporting into unsupported advertising.
nonlocal
I like it. I would say that I think the UI will have to be less crowded and the data more prominent for the layperson. True you can get to it in 3-4 clicks at present. I think there current published metrics are fine and I'm sure they're looking to measure and publish more. Overall, I think it is a remarkable step forward.
ReplyDeleteThere is a distinct difference between the institutions that have managers that are involved in more than mere scheduling issues (how many nurses and aides called in sick today?) and those who are dedicated to improving healthcare delivery.
ReplyDeleteI've worked in both types, and the contrast is startling. Good healthcare starts with a positive cultural atmosphere whose foundation is the administration. And by that I mean people who get it.
I am impressed that these centers are publishing their data. Time after time we see that when a problem sees the light of day improvement follows. The trick is to keep moving the spotlight, to not get bogged down on one project. Measurement is the heart and soul of quality. Find a problem. Take a measurement. Adjust. Remeasure.
And...you have a 'typo' in this thread: (The Other)U of M did not eliminate central lines. They eliminated central line INFECTIONS. A big difference.