Sunday, December 6, 2009

Hospital Boards More Concerned With Financial Issues Than Patient Safety?

I'm not a gambler. Never been to Vegas and it's not even on my bucket list, much less my radar screen. But I am willing to bet that, if you asked any living, breathing human being with half a brain: "What should a hospital's Number One priority be," the response would be universal: quality of care, and patient safety.

However, a recent survey of hospital boards reveals a shocking result: quality of care is taking a back seat to the business and financial aspects of running a hospital. Sixty six percent of the 722 Hospital Board Chairs surveyed listed quality of care as third on the list of priorities, which was not suprising to one former hospital CEO:

The study results are not surprising, said James L. Reinertsen, MD, a health care consultant and former hospital CEO. He was not involved in the study.

"Boards tend to think that quality and safety are already pretty good or OK and that it's not an issue," Dr. Reinertsen said. "They're looking for leaders at the board level and executive leadership to work on financial issues, strategic issues, growth issues and the whole list of what I'd call 'business issues' within health care systems. They take the core business of delivering care kind of for granted."

"Growth" and "business issues" more important than quality of care? Now think of all the fancy ads and brochures and websites hospitals pour millions into that tout--you guessed it--quality of care. Come to think of it, I've never seen any hospital ad campaigns that said: "Our number one priority is the business of growing our hospital."

This survey proves the obvious: hospitals are a business. Like any business, if they run it ethically and don't cut corners with patient care, they deserve to make a profit. And grow and prosper. But when committment to patient safety and quality of care is not "Job One" (as Ford Motors used to say), what follows is obvious: a pattern of preventable medical errors. If you think this is an isolated problem, I invite you to read a recent nationwide report that chronicles the scope of egregious medical errors in the U.S: Dead By Mistake.

These two recent news items surface at a critical time, as hospitals and their insurers are lobbying for national medical liability reforms that limit what injured patients can recover when legitimately harmed by preventable medical mistakes.

The lesson: there's a lot going on behind the curtain of fancy ad campaigns, both on the floors of hospitals, and apparently in the Board rooms as well. And some of it is not good.

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