Extend focus beyond hospitals to truly improve healthcare

by Thomas Dahlborg The healthcare industry focuses on clinical quality outcomes at the hospital level, especially on preventable readmissions. Funders of healthcare implement both carrots and sticks (incentives and disincentives) to improve quality in this area; however, this sole approach is not enough. Healthcare is a complex, adaptive system (as is each of our patients, practitioners and organizations), so a focus limited to hospital responsibility regarding care quality is not enough to truly make a difference. For this discussion, let's expand our view to primary care as well. Primary care physicians miss between 40,000 and 80,000 diagnostic opportunities per year, which lead to considerable harm to patients, according to a study published in the Journal of the American Medical Association. These missed diagnoses often include serious illnesses, such as acute renal failure, pneumonia, cancer, angina, cellulitis, hypertension and urinary tract infections. Hardeep Singh, M.D., chief of the Health Policy, Quality and Informatics Program at the Houston Veterans Affairs Medical Center and associate professor at Baylor College of Medicine, recommends the following as possible solutions: "physicians' greater use of electronic decision support tools and mandatory, structured recording and coding of presenting symptoms, rather than simply diagnoses." At a minimum, he believes these improvements "would help healthcare systems better track these errors." Expanding healthcar...
Source: hospital impact - Category: Health Managers Authors: Source Type: blogs