Transparency in health care can be a powerful tool for ensuring patient safety. But, it is too often not taken into account when considering patient safety measures. As a result, serious mistakes may happen in hospital or at the doctor’s office, and no one can learn from them. Or, a medical device, such as an artificial joint may have a design defect, and few people will know not to use it.
Medicare collects and reports some important patient safety information, including how hospitals rank on two types of avoidable infections and eight different types of avoidable complications such as bed sores and blood clots. It’s worth looking at this information to see how your local hospitals rank. And, Consumer Reports also offers some patient safety data. That said, there’s a lot of critical information that’s not available to the public.
The National Patient Safety Foundation’s Lucian Leape Institute is working to promote the benefits of transparency in health care and to demonstrate that the risks are minimal. Its recent report, Shining a Light: Safer Health Care Through Transparency, offers dozens of recommendations for providers on everything from safety data collection, to building a culture of safety, affording patients good information to make informed health care choices, and sharing best practices with other provider groups.
Transparency is hard to achieve because hospitals and other providers worry about how information that shows medical errors and poor quality can hurt reputation. People also can easily misinterpret some quality measures. For example, patients may be readmitted to the hospital because their condition worsened but people may wrongly assume it was because their care was poor.
The Leape Institute demonstrates the benefits of disclosing safety information. The data suggests that disclosing medical errors has not increased malpractice suits or cost hospitals more as some may believe. And, one national pediatric hospital collaborative that banded together to identify the biggest harms and stress safety to improve performance were able to reduce serious harm by 40 percent.
It’s not just hospitals. I recently had a Spinal Cord Stimulator inserted to help with my chronic back pain. Before agreeing to the procedure I got five “second opinions” most of which were favorable. It’s working fine but…I got absolutely no written instructions; almost all of my information came from two sales reps for the manufacturer; they “forgot” to tell me not to bend or twist for at least six weeks after surgery; the practice consists of a surgeon, a doctor and two physician assistants; I saw the doctor one time before surgery; I saw the surgeon for the first time on the day of surgery and have not seen him since; the manufacturer’s help line doesn’t – when my turn comes the line goes dead and disconnects and the sales reps (not physicians) are not very knowledgeable. I’m surviving but only because I’m persistent in following up on issues as they arrive.