Condemned to repeat it
This much we know: Quality improvement stalls and Scott’s not learning
Notes on the news: Let’s talk a little about attention. My colleague David May noted last week on this page (April 12, p. 22) that recent data showed progress in patient safety to be a mixed picture at best.
As if to underscore the point, the government then issued a new and dismal study on quality. In its annual report, the Agency for Healthcare Research and Quality said hospitals in 2007—the latest year for which data were available—continued to see increased rates of postoperative sepsis and catheter-associated urinary tract infections. The report cited “very little progress” on eliminating hospital-acquired infections and called for “urgent attention” to the task of correcting the situation.
One silver lining in the study: There was a 12% drop in postoperative pneumonia.
The depressing news comes a decade after the Institute of Medicine turned a national spotlight on the epidemic of medical errors and preventable deaths.
Just before the government issued its report, quality guru Lucian Leape addressed the American Organization of Nurse Executives’ annual meeting in Indianapolis. As reporter Joe Carlson recounted (Reporter’s Notebook, ModernHealth care.com), Leape didn’t pull any punches in his assessment of the current state of affairs: “I think it’s safe to say the patient-safety movement has been a great failure.” He added, “No one to my knowledge has implemented all 34 protocols from the National Quality Forum. Why not? Why isn’t that priority No. 1 for all hospitals in America?”
Leape’s comments were echoed by Joan Thomas, a registered nurse and a University of Memphis (Tenn.) associate professor. She said, “Maybe there have been a few tweaks here and there, but no transformation has come.”
Things may change soon. The new health reform law calls for penalties for hospitals with high infection rates starting in fiscal 2015.
It’s certainly possible to change. Carolyn Clancy, AHRQ’s director, said projects have shown that you can reduce infection rates with an intense focus on safety procedures.
So here’s a management exercise: If the staff at your institution isn’t paying attention to patient safety, what is it focusing on instead—and why?
And speaking of management, it appears Rick Scott has become the Rod Blagojevich of healthcare.
Last week, Scott, the former chief of Columbia/HCA Healthcare Corp., announced that he is running for the Republican nomination for Florida governor. As some will remember, Scott caught the attention of the industry by turning Columbia into a corporate bulldozer that wound up paying a $1.7 billion fraud settlement with the federal government. Years after his ouster from the company, Scott resurfaced as leader of Conservatives for Patients’ Rights and deluged the airwaves with ads suggesting that reform legislation would force Americans into healthcare gulags.
Having lost that war, Scott’s campaign said he planned to open his bid for governor with a $1.5 million ad buy. Meanwhile, the management at HCA, which is planning an initial public offering, must be cringing at the thought of Scott calling attention to the unfortunate past. It’s unclear how much they need to worry about this—the news media flits from one story to another with no memory of the past, and most Americans have the attention span of gnats.
If Scott loses this new campaign, which is likely, there will be many opportunities to indulge his ego. Like Blagojevich, the disgraced ex-governor of Illinois, he can go on “Celebrity Apprentice” and get himself fired. Or he can get his own radio talk program. Or he can run for president.
One way or the other, Scott will make sure attention is paid.