This article on NPR is chiefly about the dilemma that hospital administrators are facing as escalating government reporting requirements are being tied to their Medicare payments. (For my non-US readers, Medicare is the U.S. government medical insurance program for seniors and retirees. It pays a huge portion of hospital’s revenue, and thus, its policies carry a lot of weight).
The article’s lead does a good job of summing up the issue:
Under laws in more than two dozen states and new Medicare rules that went into effect earlier this year, hospitals are required to report infections — risking their reputations as sterile sanctuaries — or pay a penalty. That’s left hospital administrators weighing the cost of ‘fessing up against the cost of fines.
So, in effect, the administrators are faced with weighing the financial impact of lost Medicare payments vs. the financial impact of telling the truth about their infection rates. This is, in my mind, yet another symptom of the General Motors style of management that is taught by every MBA program in the world.
It also suggests that there is a viable alternative of continuing to maintain the illusion that it is not a problem.
Is it a problem? Hospital infections kill about 90,000 people a year in the USA. Compare that with the 40,000 or so that are killed in traffic accidents, and you get the idea.
Add to that the fact that the patient ends up getting billed (and usually insurance pays the bulk) for the treatment of these infections.
Fundamentally this is about quality, and the problem is certainly not limited to health care. (it is just that lives are at stake)
How does your company respond when there is a known issue that is impacting quality?
If you deliver a defective product or service, do you charge your customers for the rework? This is not a facetious question. Some companies do.
Do you avoid collecting information for fear of revealing the true magnitude of a problem?
Do your workers fear bringing it up when they are directed to carry out inappropriate actions, or actions which violate the company’s written policies and procedures?
Is it OK to improvise outside of your known process in order to get the part out the door?
Back to the hospital – we know how to tackle this problem. It is merely extremely difficult. That doesn’t make it impossible. I am glad it is getting attention. I am disappointed that it takes government generated threats of visibility to get action.
Thanks for sharing your thoughts on Reduce Your Health Care Costs.
Regards
I think that this is a really interesting piece that is essentially talking about quality control in an organization or in a company. Here, the government threatens to penalize hospitals that do not disclose their infection rates. Hospitals do not want to do this though because then they are putting their reputation on the lines and people will not want to come and get treatment, meaning that they will lose out on revenue. So now hospitals are faced with a dilemma (which they shouldn’t be but yet they are). It is the typical way that many problems are dealt with, ‘do this or be punished’. What if instead of threatening to punish them if they do not do it, we reward them for doing it? By threatening to punish, you deter people from looking and reporting errors. Then in turn, quality dips and once one hospital finds out that is what another is doing, they be more likely to do it as well because they want to be competing on a level playing field. If, instead, hospitals are rewarded for reporting infections, they may be inclined to actually report errors. Then they can be handled, improving the quality of care and reducing the amount of lives lost each year.