The United States spends nearly twice as much on healthcare as the 35 developed nations in the OECD (Organization for Economic Co-operation and Development), and yet, the US ranks last when compared with 10 of those nations on quality, access, efficiency, equity and health outcomes. It seems that money doesn’t necessarily buy the best. If spending billions of our nation’s GDP on healthcare doesn’t result in a healthier population, is there anything that can be done to improve patient outcomes?
Money has been at the center of health care improvement discussions for decades. Anyone who has been in the profession for any length of time knows the history of payment models for hospitals and physicians, including the current Fee for Service model and Pay for Performance (P4P). There are pros and cons to both, but it’s worth asking the question again; What if physicians were paid more for improving patient outcomes?
The downside of any P4P model is that physicians might hesitate to treat clinically complex patients, there is no standard for evaluating outcomes, and financial incentives need to be big enough to matter. However, we think Pay for Performance can work. So do the authors of an opinion piece in the New England Journal of medicine. They believe that it is possible to “unlock the potential” of improved quality and outcomes by “measuring a minimum sufficient set of outcomes for every major medical condition — with well-defined methods for their collection and risk adjustment — and then standardizing those sets nationally and globally.” That might work, but only if physicians buy in.
Unfortunately, physicians today are squeezed from so many sides that patient care becomes only a fraction of the medical practice equation. The headaches of running a practice; billing, coding, reimbursement pressures and building patient volume are driving physicians out of private practice and into the arms of their affiliated hospitals. That isn’t improving outcomes either. It’s not even moving the needle. Research published recently in the Annals of Internal Medicine reported a 2-year study of 803 hospitals that converted to #physicianemployment. Despite the fact that all physicians were fully employed by the hospital, there was no improvement in 4 metrics; risk adjusted hospital mortality rates, 30-day readmission rates, Length of Stay, or patient satisfaction scores. So where does that leave us?
Too Simple to Be Overlooked
A wise man once said “All the answers you need are inside of you,” and that is true for healthcare. Improving outcomes demands gathering data from the front lines. Physicians and patients can tell us what needs to be done to improve care- all we have to do is ask. Are doctors and nurses being asked about what is happening across the spectrum of patient care? Do they feel free to report errors and patient safety issues? If not, quality of care and outcomes are not going to improve.
Is anyone asking patients, in real-time, about their care? If they can’t give feedback about their care as they receive it valuable insights may be lost.
If hospital administrators are not asking important questions of the very people delivering and receiving healthcare, then true change will continue to occur at a snail’s pace. Imagine what would be discovered if some of these questions were asked regularly?
- Do you believe that mistakes lead to improvements in patient safety at your hospital? See our culture of safety questionnaire
- Are our processes effective at preventing patient safety errors?
- When an error occurs, do we examine processes – not people?
- Do clinical staff have the competence to care for clinically complex patients?
- As a patient, how would you rate our education on your medications and possible side effects?
- How would you rate your communication with the doctors?
The Committee for Economic Development of The Conference Board, a public policy organization said it best, “The greatest improvements in cost and quality can be achieved by a market-driven system based on value-conscious consumer choice.” We couldn’t agree more. That is why we develop innovative products that facilitate real-time reporting and communication for healthcare providers and patients alike.
When a patient has the opportunity to tell you how they feel about their care, they feel empowered, and acknowledged. Using HCXP for rounding and point of Care (POC) collection of feedback data, allows patients to do this. The result is a better patient experience and that ultimately leads to a better HCAHPS scores and a greater reimbursement. Find out more at HCXP, creator of a five point, 5 Star rating system for all in house satisfaction questionnaires and one comparison/benchmark reporting system.