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Following a Blog on a Blog

Well, not quite a blog in the truest sense, but a Facebook version of a blog. Here is a recent conversation on Facebook about public reporting of hospital infection rates! Bottom line, whose burden is it? The hospital's burden of data collection, measurement and reporting? Or the patient's burden of dieing or going through the pain of treatment to survive? At some point we have to get to the bottom line. We all deserve to know the basics about the quality of the hospitals that serve us. Thank goodness the hospitals in Memphis get this and report!(see their results) If you are interested in joining the Facebook group for "Transformation Has Begun" where these conversations happen daily, let me know at ctravis@memphisbusinessgroup.org. Give me your facebook information and join the conversation.

P:Three big hospitals stop publicly reporting infection data-per Consumer Reports...and there's more... Two of them are in Aligning Forces markets. (Cleveland and Detroit). Terrible. Really."Three big-name hospitals stop publicly reporting some infection data - Consumer Reports Health News ... Three large hospital systems—Cleveland Clinic, Henry Ford in Detroit, and Parkview Health in Fort Wayne, Ind.—have stopped reporting data on hospital-acquired infections to the Leapfrog Group, a nonprofit organization in Washington, D.C., according to our updated hospital Ratings. That deprives...

M: Wow. Let's wait and see how (or if) local media and patient advocates react ·

D: Wait - I was about to pop a blood vessel over this (Cleveland Clinic???) but the CU article says they only stopped reporting to Leapfrog Group - they're still reporting to CMS. Am I missing something?? Is there a special problem in not reporting to Leapfrog, which (the CU article suggests) requires a different format?

S: That's an excellent question, D. We know that leaders in the field are really struggling with the reporting burden when there are nuanced differences in measures or the formats or whatnot. 

B: Leapfrog is the only source of data on central line infections (and other important metrics like safe practices, unsafe early deliveries, and many others) that is publicly reported by hospital on a national level. That's where Consumer Reports gets the data they reference and why Leapfrog reporting is important to them. Leapfrog is nonprofit and does not charge hospitals to complete the survey. Hospitals tell us it takes 40-80 hours of staff time per hospital. That doesn't seem like an untoward burden to give consumers information they deserve before entrusting their lives in a hospital

S The HUGE difference here centers on public reporting. Transparency leads to improvement. At a minimum, it's a 'reputational incentive'. 

D: So, I don't get it - Leapfrog is non-profit, so is CMS (duh); is CMS data not publicly viewable?? And CMS doesn't charge for it, right?? That may be the case - I don't know this area, that's why all my stuff has question marks.:-) I would sure as hell hope that the taxpayer-funded CMS data would be visible to taxpayers, along with all the other HHS data that's recently been liberated - but maybe it's not! Would we (whoever that is) be happy with publishing all the CMS data? Or are there folks who are deeply committed to Leapfrog, for some reason? (Pardon my naivete)

B: CMS doesn't yet publicly report CLABSI data by hospital (nor many of the other measures on Leapfrog's survey). 

D: OH. Well that IS something! Whose a$$ do I kick about THAT?? How about if we ask Cleveland & others to PUBLISH what they send to CMS?? >

B: Go ahead. That's all Leapfrog does. The problem is you can't get your measurement experts to examine the report and make sure it's the right time period, right specs, etc. Nor can you compare them to all the rest of the hospitals nationally unless you use Leapfrog.

S: THERE'S an idea. But it's powerful when it's presented in context of how other hospitals are doing. Leapfrog does that. If each publish their own data, then it forces the patient to piece together the information from many different locations, likely described in different ways, etc. Ugh.

Cristie Upshaw Travis S, you are right on! Leapfrog and our Regional Roll Outs have had the courage, and I do mean courage, to ask hospitals to report this information and to be held accountable for their results and progress! Over 1200 hospitals report this information because organizations such as Memphis Business Group on Health ask them to do so! Over time others have asked them to report, but more than likely it is not as timely and often the results are presented in a way that the variation among hospitals is not even presented in such a way that patients and purchasers can see the differences! I could go on (LOL), but enough said. Those of us that have been committed to LF for 10+ years and have seen the difference it makes in our market are passionate (as you can tell

Cristie Upshaw Travis And, D I'd be glad to help you with your task at hand!!!

D I'll just say that this discussion is quite educational for me. Suddenly I have a much clearer sense of why it's so hard to improve things. Imagine a class of 7th graders whose parents - or principals - can't see their report cards. No real consequences for crappy performance, no rewards for improvement. Boy. Well, I don't know executives at Cleveland, but that's never stopped me... btw, in 2006 my hospital started posting their CLABSI rates on their website, and blogging about the push to zero. A few months later I learned I would get a treatment that's delivered by central line, with four separate insertions. It was, um, interesting to chat with the surgeons as they were inserting them. It made it all very relevant, suddenly. At first the hospital's competitors said it was irresponsible of the CEO to blog about it. "You're endangering your hospital's reputation." Really?? That's how Boston hospital community thinks - reputation over all? But that was a ruse; when the numbers dropped and hit zero for a couple of months, the same competitors accused him of grandstanding for marketing purposes. :-) These guys crack me up ... until I think about the consequences for families. It never occurred to me that those guys don't have ANYONE examine THEIR numbers, so they can be as schlocky as they want. Hm.

S: Oh my god, I think I've fallen in love with you, D. You GET it.

P: Wow, I leave FB for a bit and there's a giant conversation...

D: Er, S gee thanks :-), I think, but ... out of curiosity, are you talking about the years-ago episode, or today's news at the start of this thread?

P:This point about measurement and reporting burden about something so critically important to patients, consumers and the public makes almost no sense to me. Failure to work as hard as possible to get information like infection rates out to the public is really indefensible. Pathetic.

Cristie Upshaw Travis I couldn't agree more P! Whose burden is it any way? The hospitals to report or the patient's to experience the infection and either die or go through a lot to survive? Sorry to be so blunt, but at some point we have to get to the real point. But, to be balanced, we need to be sure that we are focusing on the stuff that really makes a difference. If it doesn't, let's not go there. If it does, let's go there! The obligation on our end is to know what leads to best outcomes and measure that and the outcomes but little else. When we can get to only outcomes, that will be nirvana!

 

Posted by Cristie Travis at 9:01 PM

Comments

10/27/2011 at 07:52 PM by Cyndy Nayer

Cristie, Dave, Diane-- it makes a difference. My aunt died from this. Same hospital, new family member, almost died after bypass surgery. We need to be loud on this message: we do have great healthcare, but only when applied well. Leah, you have our attention. This is not a nice-to-have, and it doesn't have to be "gotcha.". Let's reframe as "we can all help the improvement"


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