So how are you doing Doc?

There have been a couple of examples of patient care information that has been made available recently. Paul Levy of Beth Israel Deaconess hospital in Boston has posted the central line infection rates for that that hospital, (http://runningahospital.blogspot.com/2007/02/we-saved-one-persons-life-can-we-keep.html). Good for him!

Pennsylvania has a statewide hospital infections report; (http://www.phc4.org/reports/hai/05/) even better!

Now patients in Pennsylvania can go look up which hospital has the best or worst infection rates as they make decisions, (at least I hope they take this information into account), about where to have elective surgery undertaken. The critical patient hopes to see many more states and hospitals promote the publication of these important barometers of patient health.

A good framework for this was provided by the Institute of Medicine, (IOM), report, “To err is human,” National Academy Press, 2000. That is the report so often quoted as the source of the statistic that up to 98,000 people in America die every year of medical mistakes.

What is interesting, and often overlooked, is that this figure is derived from two studies in Colorado/Utah and New York. That is a small base on which to extrapolate such an important statistic nationally, and the only way that this shortcoming will be overcome, (if there is a shortcoming), is to publish the data for hospitals and clinics nationwide.

That data should include not just the infection rates, but also the adverse drug events, incorrect procedures, and error rates related to individual procedures or diagnosis.

Most patients want to get better, and by tracking resolutions by diagnosis rates by individual hospitals, patients can potentially see where the hospital with the best outcomes for their condition is. That should not be confused with the number of procedures that hospitals undertake, which is never a barometer of successful outcomes.

The IOM made several recommendations, of which one is that health organizations should be setting up safety programs within their own organizations, and reporting the outcomes of those programs to patients and other interested parties.

The critical patient completely agrees with this recommendation, but sees limited evidence that this is happening. Do you know if it is happening, and we are just not seeing it in the information overload?

If we expect patients to make good health care decisions, then as practitioners, we have to make the data for them to do that available.

Thanks,

Foster