Tuesday, March 24, 2009

At the ACHE

Jim Conway, Senior Vice President of the Institute for Healthcare Improvement, invited me to join him at the annual meeting of the American College of Healthcare Executives in Chicago. ACHE is an international professional society of more than 30,000 people who lead hospitals, health care systems, and other health care organizations. About 1300 showed up for our 7am session this morning, entitled "Transparency and Leadership in Quality and Safety Measures."

The pictures show some of the attendees, looking remarkably chipper given the early hour, from Tennessee, Texas, Florida, and elsewhere. Also, there's Howard Horwitz, ACHE's education vice president. Finally, there are the labeled water glasses to prove that Jim and I were actually there: These guys are serious about infection control! (But it gave me a chance to joke that I did not see if the man who put on the labels had washed his hands.)

I always learn something when I hear Jim talk. The takeaway moment for me was when he displayed a chart showing survey results about the "top issues confronting hospital CEOs." In 2008, 43% percent of those surveyed indicated that patient safety and quality were among their top three concerns. This is an improvement from 2003, when the figure was only 26%. That's the glass-half-full interpretation.

Jim's interpretation, in contrast, is that 57% of the hospital CEOs surveyed did not have safety and quality in their top list of concerns. This is a major indictment of the health care system and demonstrates a lack of understanding of the concerns of a broad group of stakeholders -- patients, families, public interest advocacy groups, business leaders, governors, and legislators. I do not know if we were preaching to the choir today, or if we were able to make some converts.


Anonymous said...

Thanks for the stimulating ACHE presentation yesterday morning by you and Jim Conway – information, encouraging and provocative. Why is this taking so long? I don’t yet discern a collective/passionate outrage for patient safety change across the industry. Jim’s quote about “Why didn’t anybody do anything?” is so right on.

I sit in these educational and patient safety/quality conferences as a participant and sometimes a speaker. My stomach churns at the lack of aggressive progress when I know so many are still dying and hurt needlessly. I plant seeds of change during my searches for hospital CEO’s, senior and mid level management, but for too many their eyes just glaze over. Many are doing good things and change is happening, but we need so many more champions and constructive change at a faster pace. We also need a stronger, genuine and accepted partnership between patients/families and providers. We misread the motivation of patients/families about this involvement and under-estimate their value.

Dan Ford
Vice President
Furst Group
Phoenix, Arizona

Mark Graban said...

I'm glad I'm not the only one shocked that safety and quality wasn't more than a 43% concern. The people surveyed could list more than one top priority, I believe.

Finance came out on top of the survey, the self reported "top concerns". Cost and finances are not something to lose sight of, but you're right that we need more leadership from the top about quality and safety.

Thanks for setting that good example, Paul!

Lori said...

Your post about less than half of hospital CEO's not having patient safety/quality as a top priority has me wondering.....how are CEO's evaluated for job performance?

It seems that simple logic would dictate that their evaluations be tied to quality outcome measures like hospital infection and mortality rates.

Any CEO's whose facility's infection and/or preventable mortality rates are not decreasing over time should be fired. It's so simple..like the big elepahant in the room that everyone is sidestepping. Providers and front line healthcare workers are not the only ones who should take the heat when poor performance at the bedside harms patients, or worse results in untimely deaths.

We should take the current lessons we are learning about Wall Street CEO's and (urgently) apply them to hospital CEO's.

'First do no harm' should go right on up the chain.


Anonymous said...

I agree. It is certainly the case at our place, where my annual review has a major quality and safety component.

Jeff Long said...

Thanks for this post. I just came across your blog, it seems like you really care about patients and their well being as well as managing a great hospital. I plan to be reading more.