Wednesday, October 29, 2014

Up to date in Kansas

Melissa Clarkson, from Kansas, is the relative a patient who suffered serious harm from a series of medical errors, and she writes an occasional blog on her observations.  In this piece, she relates the story of attending a Summit on Quality in Wichita, sponsored by the Kansas Healthcare Collaborative (which is an organization formed by the Kansas Medical Society and Kansas Hospital Association).

While expressing appreciation for the success stories presented in the conference, she raised some doubts.  First, she noticed a paucity of negative reports, ones that would indicate the potential for learning.

I . . . wish that the presenters went a little deeper and talked about times when mistakes were made, when things went wrong, and when patients were harmed. I realize that these are uncomfortable topics, but cheering for successes is not enough. The failures and breakdowns have to be seriously discussed. Not only is there is a great deal to learn from these incidents, but there is value in simply seeing examples of healthcare professionals talking about patient harm.

Patient harm is as real as the successes that were celebrated. I encourage KHC to consider how both can be discussed.

Second, she observed, "There was much talk at the meeting about patient-centered initiatives. But at this meeting the patient’s voice was not only not at the center, it seemed to be completely absent."

I later had a chance to view the slide show presented by the CEO and CNO at the University of Kansas Hospital. There is much positive to be said about the progress of the institution, but--perhaps because of my recent blog post about Magnet hospitals--I was struck by the level of hype about this one's Magnet recognition and also its rankings in US News and World Report.

Every single slide in the 52-slide presentation was framed with emblems from these two organizations. Here's an example:

And here's one that reeks of non-substantive self-congratulation:

Why a hospital would choose to place such emphasis on designations like these when it has so much good to report is beyond me.  I guess it is a statement of the degree to which both Magnet and US News have inserted themselves into the marketing mindset of US hospitals.


Disillusioned Nurse said...

As a nurse employed in the ICU of a tertiary care hospital in Asheville, NC, I can attest that the decade long investment in the pursuit of Magnet Status has resulted in the LOWER quality nursing care over this time. Finances that might have been used to provide adequate staff compensation have been diverted to pay for all that it takes to achieve Magnet Recognition. Employee wages are stagnant. PTO had been reduced, resulting in nurses and other staff working sick or without vacations. Employer Retirement Contributions have been reduced, causing increased stress and distraction amongst hospital staff. Employer provided health benefits are abysmal. Perhaps if resources were directed toward the nursing staff themselves, a healthy productive workforce would provide the very care they wish to claim to have. Then again, I have yet to see a hospital market “We treat our Nurses well”.

Of note, the hospital I work for has yet to obtain Magnet Status.

Melissa Clarkson said...

Thanks for the link to my blog, Paul.

As a person outside the healthcare system it is difficult for me to judge quality of care -- but I can react to what information is presented and how it is presented. It is important to note that the presenters had data showing that employee turnover went down and patient satisfaction went up over time, and those are surely signs of an improved environment for both staff and patients. And they did say a few times that it was "about the patients". However, the details and stories were about themselves and achieving these recognitions. And they successfully communicated exasperated exhaustion in their journey to securing these recognitions. I kept thinking during the presentation that I hope that these recognitions have some solid patient safety data behind them.

I realize that it is easier to point to recognitions and awards than the messy reality of patient care, but ultimately I care about the care.

Anonymous said...

Thank you for the notice. I have been brushed off by the executive board of a "#1" hospital. They can't answer care questions - due to mistakes like what you mentioned.

The growing lack of trust in medicine is the default of admins and some for docs when they don't start working together to take meaningful help in the eyes of patients. One shouldn't have to resort to law courts for answers.