New study suggests such public measures may not tell the whole story
Article Source: msnbc.com
from:msnbc.comHospital quality rankings may miss the sickest
Seeded on Fri Dec 3, 2010 9:46 PM EST (msnbc.com)
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Ever since JCAHO has been doing these ridiculous inspections, patient safety and 'quality' hasn't improved one bit. But, here's what's happened. The amount of red tape that nurses have to wade through on a daily basis tie them up so much that they no longer perform the function of a nurse. Their jobs have become one giant checklist from beginning to end. There are entire FLOORS of hospitals dedicated to 'quality', yet 100,000 people a year still die in hospitals because of mistakes. WTF.
Stop the madness. Let the nurses get back to nursing.
I can't argue with the above comment. Additionally, if real quality were somehow measured-that of how the patient felt about his or her hospital stay, whether the diagnosis was correct, and whether the patient actually improved or not-I doubt a lot of hospitals would actually stay in business!
Hate to sound cynical, but during my last hospital stay (and I am a healthcare worker who has worked in hospitals for years), I never received the correct diagnosis, I was terrified the staff would kill me or at least let me die, and more than once I was either completely ignored when I begged for help or I was told by a nurse (2 different nurses) that she "wouldn't help ME." I was neither uncooperative nor abusive at any time. (They were, however, the best I've ever seen with bedpans, and I told them so.) I have never been so happy to be d/c in my life, though my problem was not addressed for another month; and it had to be addressed as an outpatient. As a result of all that, I was bedridden for about 2 months.
I agree that the Joint Commission is a bureaucracy that is out of control. It adds excessive regulation without any concern for the cost nor proof of benefit.
As far at the 100,000 deaths a year -that number comes from another out of control entity, the Institute of Medicine. Their methodology for coming up with that number was ridiculously flawed. (i.e. they considered any one who died in an ICU as a preventable death -regardless of the true cause). The real number of preventable deaths is probably dramatically lower than 100k. People in the health care business have just decided not to argue about the number, but have instead decided to agree that there is a need for improvement -which is true -it's just that things are not nearly as bad as what has been popularized.
JCAHO and CMS reviews rarely deal with real issues that would concern me as a patient. They review paperwork intensely.
One of 3 hospitals in which I work was recognized for having the lowest incidence of death from heart attack of any in the state. That was because it transferred all its patients with heart attacks to another facility with a heart surgeon and better facilities. Patients who died in the ER were apparently not included because they were never admitted. The cardiologists at the center that received the patients were obviously upset because their stats were unfairly designated as worse because they took patients too sick to stay at the referring hospital.
The JCAHO is a farce and so is the Institute of Medicine! They justify their own existence by finding fault without coming up with any solution other than to require more paper work from hospitals already overburdened by that same paper work.
Look up the medical personnel who represent the Institute of Medicine. They are generally second-tier academicians who spend little, if any, time directly involved in patient care. Most are not MDs. Their infamous ruling, as RDH mentions, on mistakes made in patient care, is an extrapolation of their findings in a few teaching institutions. The hospitals were in Colorado, Utah and the New England area. The patient selection and means by which "adverse reaction" were determined were both flawed and in any case, the doctors involved were frequently doctors in training, not experienced clinicians.
The last time the JCAHO visited one of the hospitals where I work, a retired psychiatrist wrote an adverse report on that hospital because he did not like the way the medical oncologists calculated the chemotherapy doses. He had no experience in doing it himself and I doubt he knew anything about chemotherapy otherwise.
The JCAHO has told that same hospital that nurses are to stop mixing chemotherapy drugs and to turn that duty over to the pharmacists. The nurses have had an average of 10+ years of experience in oncology, including mixing and measuring chemotherapy drugs. They also have to look the patients that are receiving those drugs in the eye as they give them. The pharmacists, who are now being trained to do this, never look at the patients. The times when anyone has been charged with fraud because drugs were stolen and inert materials were given to cancer patients were when unethical pharmacists committed the crime. Yet the JCAHO continues to make bad rulings and interfere with patient care.
I find it touching that these dear hearts actually put their noses to the grindstone and did this study; they exposed a statistical con job and it shows there are still some doctors who really care about this country and its people. A few, but they're still around.