The sad story of Rory Staunton, the young boy who died of sepsis infection, has been prompting a lot of commentary. I have noticed that is the nature of press coverage that it often takes a sympathetic figure to get attention to a long-term, systemic problem in the health care system. I have written here of the efforts of Dr. Jim O'Brien and others at the Sepsis Alliance to help doctors and nurses learn of the early warning signs of a sepsis infection. Let's hope that the recent story will give a greater impetus to the expansion of training about this important clinical problem.
But it is not of that topic that I write today. Instead, I would like to explore the obligation of the dominant health care provider in the region to become a force in reducing harm and improving quality and safety in its own institutions and beyond. I am prompted to do so by a banner advertisement that accompanied Maureen Dowd's story today about Rory Staunton. Here's the ad:
When you see an ad like this accompanying such a sad story, you are tempted to click through to actually see how "Partners is changing health care for the better" with regard to the types of issues elicited in the story. What do we find?
Well, not much about the topic at hand. While some other stories are included, a pervasive theme seems to be about cost. Also, part of the messaging is meant to undermine reports done by the state's Attorney General about the disproportionate level of rates received by this provider group:
I don't mean any of this to suggest that this provider group is not trying to provide excellent care. I know many of its doctors and nurses and have found them to be impressive and well intentioned people. It just seems that this provider system is so intent on messaging for political purposes that we don't get to learn what they have done about the kind of misdiagnosis and mistreatment seen in the Staunton case, or for that matter what they have done to eliminate harm in other settings. After all, there are many impressive and well intentioned clinicians throughout the United States who still collectively represent the fourth or fifth ranked public health hazard in the country.
I have noticed that the media in this city gives this provider group a bye on these issues. Perhaps the reporters are so busy covering legislative debates on cost issues that they don't have time or inclination to see what's being done--or not being done--to stop killing and maiming patients.
So, here's my suggestion to enterprising reporters. Let's consider who in Boston is most associated by the public at large with ideas for improving the quality of care. Among that group is clearly Dr. Atul Gawande, a physician in this very provider organization, who has done superb work in this field. A reporter might compile a list of the major conclusions in Atul's books and articles. Then, the reporter could take Atul's recommendations for improving the quality of care delivery and see the extent to which they have been adopted by his hospital and by the entire health care provider network in which he works.
Several years ago, I noted:
The Partners hospitals are full of well intentioned, dedicated people. But there has not been a corporate public commitment to reduction of harm and to transparency of clinical outcomes that could help build broad public confidence in the quality and safety of patient care.... Ironically, some of the world experts in these matters are faculty members in his hospitals. The Partners system should be a world leader in the science of health care delivery, along with the fields in which it already holds prominence.
I'm not saying all of Atul's ideas are necessarily the right ones for all organizations, but should not the major provider group be held accountable to show how they have implemented his ideas, or if not, why they have not? Who knows? There might be some good news on this front worthy of publicity. If so, perhaps future banner ads will click through to more relevant success stories.
But it is not of that topic that I write today. Instead, I would like to explore the obligation of the dominant health care provider in the region to become a force in reducing harm and improving quality and safety in its own institutions and beyond. I am prompted to do so by a banner advertisement that accompanied Maureen Dowd's story today about Rory Staunton. Here's the ad:
I don't mean any of this to suggest that this provider group is not trying to provide excellent care. I know many of its doctors and nurses and have found them to be impressive and well intentioned people. It just seems that this provider system is so intent on messaging for political purposes that we don't get to learn what they have done about the kind of misdiagnosis and mistreatment seen in the Staunton case, or for that matter what they have done to eliminate harm in other settings. After all, there are many impressive and well intentioned clinicians throughout the United States who still collectively represent the fourth or fifth ranked public health hazard in the country.
I have noticed that the media in this city gives this provider group a bye on these issues. Perhaps the reporters are so busy covering legislative debates on cost issues that they don't have time or inclination to see what's being done--or not being done--to stop killing and maiming patients.
So, here's my suggestion to enterprising reporters. Let's consider who in Boston is most associated by the public at large with ideas for improving the quality of care. Among that group is clearly Dr. Atul Gawande, a physician in this very provider organization, who has done superb work in this field. A reporter might compile a list of the major conclusions in Atul's books and articles. Then, the reporter could take Atul's recommendations for improving the quality of care delivery and see the extent to which they have been adopted by his hospital and by the entire health care provider network in which he works.
Several years ago, I noted:
The Partners hospitals are full of well intentioned, dedicated people. But there has not been a corporate public commitment to reduction of harm and to transparency of clinical outcomes that could help build broad public confidence in the quality and safety of patient care.... Ironically, some of the world experts in these matters are faculty members in his hospitals. The Partners system should be a world leader in the science of health care delivery, along with the fields in which it already holds prominence.
I'm not saying all of Atul's ideas are necessarily the right ones for all organizations, but should not the major provider group be held accountable to show how they have implemented his ideas, or if not, why they have not? Who knows? There might be some good news on this front worthy of publicity. If so, perhaps future banner ads will click through to more relevant success stories.
