An e-patient call to arms

E-patients, this is a call to action. Now. I want you to go express yourself on Paul Levy’s blog.

Most readers of health policy blogs know what a costly, inefficient mess healthcare in America has become. Paul Levy would like the people in his business to work together to fix that. Wouldn’t that be nice?

Last month he proposed that all the hospitals in the area band together to share information about how to solve problems like hospital-acquired infections. (He’s already been posting his own hospital’s failure rates on their web site, for people to monitor as they work to improve it.) And on 12/21 he proposed that hospitals not only share data, but work together to figure out how to prevent problems, so you and I don’t have as much chance of being harmed during our stay in all their hospitals:

What if all of the hospitals in the Boston metropolitan area — academic medical centers and community hospitals — decided as a group to eliminate certain kinds of hospital-acquired infections and other kinds of preventable harm?

And what response has he gotten? NOTHING. From his post today:

Look at the non-response to my challenge to all the Massachusetts hospitals on this matter a few weeks ago. I don’t think I am being egotistical to expect at least one hospital administrator or someone from the state hospital association to contact me and say, “Yes, let’s try it.” Or even have one of them say, “That’s a dumb idea.” No, the response is silence.

The subject today was the big national news story about how using checklists reduces medical harm. (He has links to it.)

To ordinary citizens it’s obvious that checklists make sense, but many doctors are acting like it’s some weird controversial idea, or maybe just some fad.

The thing that really irks me is that in the comments, it seems like almost the whole medical establishment is saying “But I don’t WANNNA do it different. It’s too HAARRRD.” Here we have clear evidence that checklists reduce harm, but these intelligent people seem to be whining “But they were mean to us when we were in med school. We LEARNED to hide our mistakes. It’s not our fault” or “It’s too HARD to change culture.”

Well, it’s not. Charlie Kenney of Cincinnati Children’s (another exemplary hospital) commented about how they’ve made the change, and he names names of his people who were brave enough to put patients first. (Ya think??)

There is not enough patient voice on that discussion. One other blogger patient besides me, the famous Pregnant Stephanie, said “Bring on the check lists!” And that’s where you come in.

Go torch that thread. Set the place on fire, burn it down. Go say what YOU think about whether hospitals should adopt checklists. Tell the doctors and administrators to listen. And ask ’em what the blazes they’re talking about when THEY don’t put patients first.

Click here to read the post and its comments, and add your voice. And yes, let’s get radical: DEMAND that they put patients first. Click here. Really.


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8 Responses to “An e-patient call to arms”

  1. John Grohol says:

    I think Paul Levy is being a little naive if he thinks suddenly hospital CEOs — who answer to their board of directors and shareholders first, patients second — are going to set aside decades worth of competition because another CEO asked them to on a blog.

    We’ve come a long way, but not so far as to change the fundamental rules of business and competition. While I’m surprised top-level hospital CEOs don’t already meet on a semi-regular basis to discuss general “running a hospital” issues, a *blog* invitation generally isn’t the way to go about setting up such a conversation or discussion (keeping in mind that many (most?) hospital CEOs don’t read blogs to begin with).

    If you want a real discussion and conversation about these issues, put a phone call into each CEO’s offices, and setup a meeting. This is still how business is done and Paul Levy knows that.

  2. > hospital CEOs — who answer to their
    > board of directors and shareholders first, patients second

    Yeah John, exactly. And I don’t want to seem intolerant, so I’ll ask as gently as I can: if those directors don’t have patients as their priority, what is their priority?

    Beth Israel Deaconess is far from perfect. I’ve spoken openly about mistakes that were made in my care there (although the oncology team and my surgeon were brilliant). But I also know that Levy frequently says on his blog that change like this requires complete support by the board.

    Here’s an informative post from nine weeks ago: No retreat by the Board, citing a board retreat that ended with “a four-year commitment to eliminate preventable harm and to dramatically improve patient satisfaction.”

    Grand idea. I’d welcome ideas on what we could do to change the priorities of other hospitals’ boards, to align with that, so (just as you suggest) the actions of their CEOs align with that goal.

  3. And, btw, I think it’s a little bit pathetic that he got not a single word of response, not even from a single hospital.

    Who’ll be the bold one? Who’ll be first to say “That’s a fine idea but it can’t work unless x,y,z.”

    And in light of the above, I guess I’m not talking to the hospital staff – I guess I’m talking to the boards. Board members, what do you think?

  4. Do I hear single-payer, universal healthcare system?
    This kind of story just wouldn’t exist, in that form, in France, where the hospital budgets are payed by taxes and where plans are made 5 years in advance, because that is what is required to make real changes in the healthcare system.

  5. Paul Levy says:

    There is no indication that hospitals in a single payer environment do a better job with regard to avoiding harm to patients.

  6. Good to see you here, Paul.

    If that’s so, then what’s the key?

    From my (humble, limited) reading of books and blogs, I have the impression that a lot of organizational behaviors could be explained by asserting that organizations try to postpone costs, pushing them downstream to whoever’s carrying the ball a few years later when a crisis arises.

    That’s not directly what Gilles was talking about but let’s explore, if we could.

  7. Baby says:

    There is so new for us! Thanks!

  8. Теперь я скажу несколько слов о подводке к дичи молодой собаки и о ее стойке.(В работе собаки по дичи следует различать 4 момента (подразделения) ее работы:

    1 — поиск, длящийся до того момента, как собака начнет причуивать признаки присутствия дичи в доступном для ее чутья расстоянии;

    2 — потяжку — работа собаки, разбирающейся в донесшемся до нее запахе до момента окончательного определения ею наличия дичи; эта работа заканчивается

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