Wednesday, August 08, 2007

Disclosure action by the PHC

Jessica Fargen, on the Boston Herald blog, reports that the state Public Health Council, the policy board for the Massachusetts Department of Public Health, is weighing a set of recommendations that would require every hospital in the state to report certain hospital-acquired infection rates to the public or to a state-sponsored agency. In particular, the public would get to see bloodstream infections associated with central venous catheters in ICU patients; surgical site infections from hip and knee replacements; and rates of influenza vaccination of health care workers.

I have not yet seen the details, and I am a bit unclear about what happens to these recommendations now that they have been presented, but this is clearly a step in the right direction. (For BIDMC, you can already see some of these numbers and lots of other ones, too. We are happy to share our experience in posting these data with any who are interested.)

By the way, when I proposed similar ideas back in February, I was characterized by some of my colleagues as attempting to create a marketing advantage for BIDMC and/or proffering bad information to the public. I hope these recommendations by the PHC will lend credibility to the usefulness of this kind of disclosure and will help eliminate the feeling that we were guided by selfish motives.

Addendum on August 9: Stephen Smith also has a story in today's Globe on this topic. Check out this quote:

Christine Schuster, president of Emerson Hospital in Concord, said that hospitals across the state have already begun to track infection rates internally and that, increasingly, administrators are accepting that they need to make their operation more transparent in order to foster patient trust.

"At first, you might think, 'Oh, my gosh, I don't want to put my numbers up there.' But let's be honest: There's a tsunami coming out there regarding public reporting and transparency," Schuster said. "You can stand on the shore and get washed away, or you can get on board."


Anonymous said...

Vindication is satisfying when one has been criticized. You may not want to publish this next sentence (and don't if necessary), but maybe now it will become clear why the others wouldn't publish their data.

I am encouraged to see the inclusion of CABG site infections. We had a surgeon at our hospital, who had started the heart program and was much respected for that, who took so long to do his procedures that he had a high rate of sternal wound infections. As a pathologist, the debridement specimens were gruesome to see.
When his clearly outlying statistics were finally criticized by the medical executive committee, he retained an attorney and became very aggressive. However, his surgery times became shorter and infections reduced after that. Just goes to show, doesn't it?

Dayna said...

Accountability is never a bad thing. It's amazing when people are held accountable what can be done. I'm reminded of the New York City Crime Rate that had a dramatic drop when Police Captains were held accountable for issues that were not taken care of in their precints.

The major university hospital we go to had an outbreak of scabies not too long ago, and our daughter needed to be admitted, we were warned by someone concerned about her compromised immune system and choose a different route.

Anonymous said...

Congrats on paving the way Paul.

It is hard to be a change agent. I don't think it is always a choice, but more of a calling. Most people become comfortable in their own rhythms and often find change threatening and destabilizing. It takes a special person with vision and patience to implement change effectively.

While some may say that they find your way of leading to be controversial, I find it to be inspiring. It is good to know that a person in such an influential position is committed to honesty, integrity and excellence (minus politics). I think we can all learn a lesson about what it means to take a risk and do the right thing- even if it shakes things up a bit in our environments. The fruits of our efforts for positive change will come in time- we just have to have patience.

I wish you the best in your continued efforts be a change agent in a health care system with many wounds.

With Respect,

Katie McQuade

Anonymous 7:43

I agree with your comment about vindication. However, I would bet that the reward of positively influencing change is sweeter than the fleeting moment of vindication that comes in being right about something.

Anonymous said...

Ms. McQuade;

Nah, I'll take the vindication! (:
That said, your statement is correct; you're just a better woman than I. (And I am a woman!)