Friday, April 6, 2012

Lack of National Reporting Mandate for Hospital Infections Hurts Consumers

This article from Forbes brings together some compelling reasons for why we need more reporting of patient safety related data: Transparency & Accountability.

These principles seem to be on everyone's mind these days (see excellent recent blog by Dr. Kent Bottles in Hospital Impact on the topic). Transparency and accountability are like motherhood and apple pie - how can anyone disagree with these values? Yet we continue to struggle with achieving both as the industry grapples with just how much transparency there should be - should we report on complications related to four procedures or two? or should we not report at all.

Unfortunately, it takes regulatory mandates to get most providers to report, which has a dual edge to it. Regulatory mandates have a way of making people pay attention and try to comply; but at the same time, these mandates tend to invoke ferocious criticism - why should the government be involved in regulating quality? are the measures appropriate? why penalize instead of incentivize?

The article mentions a great potential solution - reward providers for reporting. This should be a sufficient incentive to get initial participants who can start learning from the comparative data, and hopefully start thinking about opportunities for improvement. The challenge will still be those providers who will forgo the additional payment incentive because of their philosophical disagreements with the data, methodology for collection, fear of how they will rank, and lack of commitment to performance improvement systems. The worry from a consumer or public health perspective is that the incentive winds up further dividing those providers who are motivated and therefore more likely to improve from those who have decided not to engage and therefore may become host to poor quality and patient safety processes. Will transparency and consumerism be enough at that point to get those providers to comply? or will competitive forces conspire to take some of those providers out of the market?

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