News and Media

Welcome to Quality Buzz. Quality Buzz is dedicated to bringing you all the latest news and information to help you improve the quality of your health care. We update this section weekly and hope that it will become an important resource for you.

March 04, 2010 — It’s All About You

From the Desk of Martha Hayward...

Since I took on the role of Executive Director of the Partnership for Healthcare Excellence a month ago, it has become very clear to me that my work is all about you.

The Partnership has made a strong statement of commitment to finding fresh approaches to consumer engagement by putting a consumer advocate at its helm. In my new role, I am dedicated to working collaboratively to provide and disseminate tools to increase consumer understanding of the essential role we play in safety, cost containment and decision-making.

One essential resource is our website, which has been re-designed and recently re-launched. The new design reflects our commitment to providing practical resources to consumers — both by reaching those consumers who visit the site themselves and by disseminating our resources through providers, hospitals, employers or community organizations. As always, you can help us get the word out by sharing these important resources — download our materials, customize them and print on your own or request preprinted materials.

For the last year, the Partnership has used the Quality Buzz to raise awareness of key consumer engagement issues, both locally and nationally. As I embark on my new role, I ask for your help. What topics would you like to see raised through Quality Buzz? Are there relevant things you are involved in that we can highlight through the Buzz? Please contact me by email if you would like to open a conversation about ways that the Partnership might be helpful in reaching your goals for consumer engagement.

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January 26, 2010 — What Are The Best Websites to Compare Facilities and Providers?

A shout out this week for the Informed Patient Institute. The IPI, as it is known, is a non-profit organization that is concerned about the quality of information available to consumers about health care quality and patient safety.

The IPI's website rates literally hundreds of websites that provide background, performance measures, or report cards on different types of health care facilities and professionals. The IPI staff rates each site based on criteria covering six areas – site content, timeliness, presentation, ease of use, information to make decisions and special features. Websites are assigned grades from A ("outstanding") to F ("not worth your time"). Equally useful are the comments made by IPI staff about each website. IPI promises to update its ratings annually.

IPI has an ambitious plan to rate on-line report cards for many other types of facilities and professionals, including urgent care centers, psychologists, etc. However, at the moment, it is limited to nursing homes and physicians.

The IPI website is among the new resources included on the Partnership's new website. Look for it to launch later this week. In our next Quality Buzz, we will give a tour of the exciting features available on our new site.

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January 12, 2010 — High Tech and High Touch Care

Can large academic medical centers provide the personalized and compassionate care valued by patients and their families?

This is the question posed in a recent op-ed by Douglas Brown of UMass Memorial Health Care. He notes that Clinton Hospital, the smallest hospital of the UMass Memorial Health Care system, outperforms UMass Memorial Medical Center, the academic medical center that serves as the flagship of the system, when it comes to patient satisfaction scores. Mr. Brown notes that the Medical Center treats patients who are sicker and require more complex care than Clinton and then asks why teaching hospitals aren't satisfying patients as well as Clinton.

Complex care typically requires larger teams of medical professionals – specialists, sub-specialists, various therapists, nurses, etc. Patient rooms are often crowded with equipment. Nonetheless there are academic medical centers that do achieve high patient satisfaction ratings.

Some of them are affiliated with an international non-profit organization called Planetree. Planetree was founded by a patient who had a very bad experience at a California teaching hospital. Planetree promotes the development and implementation of innovative models of health care that focus on healing and nurturing body, mind and spirit. Planetree focuses on everything from the design of facilities to the nature of the patient-caregiver relationship.

Planetree is not the only organization promoting patient centered care. However, Planetree is among the few that explicitly addresses how the design of space and the environment impacts patient experience.

Kudos to UMass Medical Center for joining Berkshire Medical Center in Pittsfield and Martha's Vineyard Hospital for adopting the Planetree model.

Hopefully, UMass Medical Center will soon rival Clinton Hospital on its patient satisfaction scores!
 

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December 22, 2009 — An Important Milestone in Patient Safety

This month marks the tenth anniversary of the release of "To Err is Human" by the Institute of Medicine (IOM). The report, which documented that medical errors were a pervasive problem across the US, generated widespread media attention and launched the modern patient-safety movement.

In marking the anniversary, several leaders in the patient safety movement have published progress reports, summarizing progress to date and challenges that lie ahead. While significant progress has been made, there is consensus that we have fallen short of goals set a decade ago.

The Partnership's Chairman Jim Conway recently joined with other members of the Lucian Leape Institute of the National Patient Safety Foundation to summarize what it would take not to simply implement recommendations established by the IOM, but to transform the health care system to achieve meaningful improvement in safety. The transforming principles include:

• Transparency – free sharing of information including sharing information with patients, including information on when things go wrong.
• Integrated care - that is patient-centered.
• Consumer engagement – as summarized by "nothing about me without me."

While there has been progress, we have a long way to go. Since our launch in 2007, the Partnership has worked to increase consumer awareness of the simple steps, such as writing down questions for the doctor, that all of us can do to increase our level of engagement in our health care. In the course of our work, we have learned that we cannot do it alone. We are grateful for the support of our Leadership Council and our partners in helping us reach literally hundreds of thousands of consumers. We look forward to continuing our campaign in 2010. Happy Holidays from the Partnership.

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December 15, 2009 — Making a List and Checking it Twice

Many of us will take to the roads and skies for the holidays. Between packing suitcases and wrapping presents, medications can sometimes take a back seat to the fruitcake. Here are some tips to make sure you are safe during your holiday travels:

• Bring an up-to-date medication safety list with you. It can save your life in case of an emergency. It gives medical personal the information they need to know to treat you in the event you can't speak for yourself. If you are traveling, it's unlikely that an emergency room will be able to access your medical record – even if it's computerized at your "home" hospital.
• Resist the urge to combine your medications into one bottle or bag. Keep them in their original bottles.
• Put your medications in your carry-on bag (and pull them out if the airline crew decides just before take-off that your carry on can't fit on board).
• If you forget pills that you must take daily, call the local pharmacy. Stores in national chains can generally access your pharmacy records on line. Pharmacists can also call your doctor's office.

Wishing everyone a happy and safe holiday season.

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December 08, 2009 — A “Game Changing” Website

Check out http://www.patientopinion.com/. It invites patients to post their wisdom and insights about the National Health Service in the United Kingdom. As the site says, "this is our National Health Service, let's make it better." Since it launched in 2006, the website has recorded and indexed close to 18,000 comments. Consumers can easily search to find all comments posted about a particular hospital. What's most amazing is that the people behind the website send the comments to the hospitals involved and the hospitals are given an opportunity to respond. The site points to several instances where comments have contributed to positive changes. Here in the US, we have report cards on hospital performance. Patients share comments on bulletin boards sponsored by support groups. However, we don't have anything like Patient Opinion... yet. It would a real "game changer" if we did.

A 50:50 Chance of Infection
An international study of patients in Intensive Care Units (ICU) revealed that ICU patients have a 50:50 chance of having an infection. The study looked at approximately 14,000 patients who were hospitalized on a particular day in 2007. Approximately 51% were classified as having an infection. It found that the longer patients stayed in the ICU, the more likely they were to have an infection. People who had infections in the ICU were more likely to die than patients who did not have infections. Infection rates in North America were slightly below the international average.

This is yet another reminder of the importance of working with your health care team to reduce your risk of getting a dangerous infection in the hospital. For simple steps you and your family can take, visit our website.
 

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December 01, 2009 — Treatment Guidelines and Me

The flurry of debate regarding the new breast cancer screening guidelines released by the US Preventive Services Task Force is leaving many consumers – including me – confused.

Do I continue to get an annual mammogram? What's the evidence for and against? What are the benefits and risks? By the way, I don't have a degree in biostatistics or epidemiology, so please remind me what a "false positive" is and why it is that bad – for me? (Emphasis here on "for me" and not on "for society.")

We should keep this debate on breast cancer screening in mind as we think about health care reform. Most health care reform proposals include a provision for evaluating the comparative effectiveness of alternative medical treatment. This Comparative Effectiveness Research would be shared with consumers and physicians (and other practitioners) to make informed decisions.

Communicating the evidence from Comparative Effective Research will be difficult. However, patient education tools (also called decision aids) can help. At the end of the day, however, it will be up to the patient and his/her own physician to work together to make appropriate decisions.

In the meantime, my list of questions for my next doctor's appointment just got a little longer.

Last night, AARP Massachusetts and the Partnership were at Salem State College for the last in our series "The Crisis in Health Care: What's A Patient To Do?" Many thanks to Salem State for hosting and its President Patricia Maguire Meservey for moderating the panel.

L-R: Martha Page, North Shore Medical Center, Marilyn Schlein Kramer, Partnership for Healthcare Excellence, Martha Hayward, Women’s Health Exchange, Mitchell Rein, North Shore Medical Center, Patricia Maguire Meservey, Salem State College

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November 24, 2009 — Quality Forum in Salem: November 30th!

This coming Monday (November 30th) the Partnership and AARP Massachusetts will be in Salem, MA for the final forum in our series "The Crisis in Health Care: What's A Patient To Do?" Salem State College is hosting the event at the Enterprise Center and its President Patricia Maguire Meservey, Ph.D, will moderate the panel. In addition to being President of Salem State, Dr. Meservy is a registered nurse and has worked for many years in both clinical practice and nursing education.

Our panelists will include: Dr. Mitchell Rein, Senior Vice President of Medical Affairs and Chief Medical Officer, North Shore Medical Center, Martha Page, RN, MSN, CPHQ, Director of Patient Safety, North Shore Medical Center and Martha Hayward, a breast cancer survivor and founder of Women's Health Exchange.

This will be a great opportunity to hear from health care providers and patients directly about how consumers can take action and become active in their own and their families' health care choices. I hope you can join us.

Last week, AARP Massachusetts and the Partnership were at St. Luke's Hospital in New Bedford. There was a good discussion among the panelists and audience.
 

L-R: Dr. EJ McMahon of Southcoast Hospitals Group, Linda Fitzgerald of AARP Massachusetts, Marilyn Kramer of the Partnership and Linda Kenney from MITSS

Wishing you a happy and safe Thanksgiving.  

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November 17, 2009 — Consumers on The “Roadmap”

Last week, the Massachusetts Health Care Quality and Cost Council released its "Roadmap to Cost Containment." With 97% of Massachusetts residents having insurance coverage, the "Roadmap" turns attention to reducing what the Council calls "unsustainable" cost increases. The report details several strategies, including consumer engagement, which have been shown to be effective. It commends the work of the Partnership for engaging and educating the public and urges us to continue our efforts and expand our messages. We are grateful for the recognition of our work and look forward to working with the Council and the Executive Office of Health and Human Services (EOHHS) to implement the strategies outlined in the Roadmap.

Last week's edition of the Archives of Internal Medicine had two academic papers that should be of interest to consumers:
 

• One study found that contrary to general perceptions, visits with primary care physicians are actually getting longer. Researchers found that between 1997 and 2005 the average visit increased from 18 minutes to almost 21 minutes, primarily due to more time being taken for physician counseling. The benefit - longer visits were associated with higher quality.
• In the second study, Boston-area researchers looked at how "adverse events" (medical errors) impact patients' perceptions of quality. Out of approximately 2,500 patients in the study's sample, 1 in 4 experienced adverse events. However, only 4 out of 10 adverse events had been disclosed by hospital staff. Curiously, patients who had been told about adverse events were twice as likely to rate their care as "good or excellent" compared to patients who had not been told. This study adds to the growing body of evidence that transparency can lead to greater patient trust and perceptions of quality.

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November 10, 2009 — Keeping Our Eye On Quality

As progress towards national health care reform proceeds in Washington, two recent reports remind us of the importance keeping our eye on quality and patient safety as we think about insurance and payment reform.

The first report comes from the Massachusetts Healthcare Quality and Cost Council. It details quality and cost data for common conditions and procedures for every hospital in the state. While this data has been available to consumers for some time on the state's "My Health Care Options" website, this new report makes it easier to compare hospitals. It shows large variation in hospital performance for certain measures, particularly for mortality (death) rates following stroke and for cost of CTs and MRIs.

Readers will learn that quality care is delivered by Massachusetts hospitals at very different costs. More expensive care does not necessarily mean better quality care or that high quality care is only delivered by academic medical centers.

The second report analyzes results of the first national survey of hospital board chairs regarding their priorities. Surprisingly, half of those surveyed did not rate quality of care provided in their hospital as a top priority for the board and less than half identified quality performance as one of the two most important criteria for evaluating the performance of the hospital's CEO. Moreover, the researchers found a relationship between Board attention to quality and hospital performance (as measured by quality rankings).

As the authors note, if we want to improve quality of care in our hospitals, governing boards may be "a tempting target for interventions." Indeed.
 

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