Most Hospitals Don't do Well on the Basics of Medicine
The New York Times has an article about the Department of Health and Human Services study that was published in the New England Journal of Medicine last month where hospitals were graded on the basics:
JUST about everyone in medicine agrees that a patient who shows up in the emergency room with a heart attack should be given aspirin. That simple treatment has been proved to cut death rates by nearly a quarter. …
Over all, Long Island hospitals delivered appropriate treatment to heart attack victims 92 percent of the time, to heart failure patients 84 percent of the time, and to pneumonia patients 75 percent of the time. …
"We really should be close to 100 percent on all of these measures," said Dr. Ashish Jha, a Boston physician and author of one of the national studies published last month. "There's not much controversy about whether giving antibiotics to someone who has pneumonia is good or not."
And the hospital’s response to this study saying they aren’t consistently doing the basics?
Dr. Lawrence Reduto, the hospital's vice president for medical affairs, blamed the way the government counts. …
and another hospital which did the worst on the list:
Hospital officials said they believed the problem was not in treatment, but in abstracting the data from charts.
As Al Franken says “Denial is not just a river in Egypt”. You can’t fix the problem, if you can’t see it. Of course the solution is in having checklists and appropriate procedures. Fortunately, some hospitals are doing this.
At Southside, a 371-bed hospital affiliated with the 15-hospital North Shore-LIJ Hospital System, administrators began planning three years ago to meet the standards. Emergency room physicians were given checklists, on paper and electronically, that specify what to do for heart and pneumonia patients.
"They don't have to remember everything, because they get reminders," said Frank del Giudice, vice president for quality management. "Everybody's busy. It's easy to miss something if you're not looking at it very carefully."
Physicians at Stony Brook University Hospital, whose emergency room is one of the busiest on Long Island, sign a form that automatically orders the necessary treatments for heart patients. If a patient should not get aspirin or beta blockers for some reason, "you have to go to the trouble of unordering them" said Dr. David Brown, chief of cardiology.
Good for them. Joining the twenty-first century and enacting standard business procedures is something long overdue in the medical profession (not to mention the legal profession). Checkout the Read the entire article. It’s worth the time.
