Monday, October 15, 2007

Good work by the MHA

The MA Hospital Association has organized its members into producing a website presenting data on falls and bed sores in the state's hospitals. Here's a summary of the program and a link to the website.

The MA Nurses Association quickly said that this was "just another public relations gimmick by the hospital industry to avoid doing what they should be doing, which is to prevent these complications from occurring in the first place." (Sorry, I don't have a link to this quote. The press release was emailed to me.)

I understand that the MNA is pursuing a certain agenda that the MHA has opposed, i.e., legislation to mandate nurse staffing ratios, but it is a shame that it could not find a way to compliment the MHA for doing something worthwhile. As I have discussed elsewhere, publication of clinical results is a highly effective way of holding organizations accountable and helping to drive quality improvement.

Is it just a sign of the times that discourse on such items has to be the victim of polarization on other issues?


Anonymous said...

Not living in MA and therefore not familiar with the details, this does appear to me to be a snippy response from the nurses. Conceivably the data from the website could be used to support their position on staffing ratios, not denigrate it.
Yes, I do believe that our national government (and I am speaking of all three branches, considering Clarence Thomas' recent book also) has set the tone for increasingly acrimonious relationships between dissenting groups of any kind. It's a shame. I don't know if it will ever change now that our human species' "dark side" has been allowed to show so openly in this democratic country.

Anonymous said...

Thank you Paul for acknowledging the hospitals' efforts. However, it should be noted that our accomplishments under our "Patients First" initiative could not have happened without our partners -- the Massachusetts Organization of Nurse Executives. They deserve equal billing.

Anonymous said...

Consider it done!

Rob said...

"As I have discussed elsewhere, publication of clinical results is a highly effective way of holding organizations accountable and helping to drive quality improvement."

Well. Yes, it's a good step, provided, of course, there IS improvement.

I guess I'm just the teensiest bit skeptical about executive responses when nurses rebel about staffing levels. There will always be about 12% (my figure) of a population who will complain no matter what. But. If there IS fire, wouldn't some of the smoke be a unionization effort?

In other words, that's a symptom. It's a symptom of a lot of things (aggressive expansion of a union and that ever-present 12%), but it has to also include that nurses ARE feeling understaffed. From my very limited experience, they ALWAYS feel that way. That doesn't mean they aren't.

When you take into account that, capital items like MRI gear and real-estate holdings aside, the two greatest advantages to a hospital are:

1) It's a big hotel where patients can easily be moved from department to department in a continuum of care

2) It houses a large pool of caregivers who can provide smooth care, even during peak times.

Those caregivers (nurses, to be loose about it) work in teams. Their own internal group knowledge is essential to how they work. When a hospital is understaffed, and nurses are forced to "float," I wonder if breaking up that social-knowledge group to fill in the staffing blanks doesn't cause real harm to care - not because of incompetence or not caring, but because you're messing with the balance of that big pool.

It's complicated, in other words, and I certainly wouldn't want your job, Paul. But unions haven't always been bad. They often are belleweathers of change. Maybe there's a change in the air. Maybe you can take this moment to understand why the unhappiness and adress it.

Of course. I'll bet you already have.