The moment that an accreditation team shows up unannounced can spike the pulse of even the most seasoned hospital executive. The next several days will amount to one big exam for the safety and quality of care, as surveyors meet with executives, managers and care teams, and watch first-hand as care is delivered. Make the wrong move or give a wrong answer, have them see rust on a ceiling sprinkler, and your hospital may get dinged. Get dinged too many times or have findings of serious patient risks, and your accreditation (and the federal funds attached to that) may be in jeopardy.
This is a useful and essential exercise. It makes sure that hospitals are doing what they’re supposed to. For example, do they have an infection prevention and control plan? Do they conduct fire drills? Do they inspect, test and maintain medical equipment? Do doctors sign their orders and notes?
Regulators have been innovating how they evaluate hospitals to make their reviews more meaningful and impactful for patient safety. Yet, if we truly want to strive for the best possible care, end preventable patient harm and reduce needless costs, meeting regulations alone isn’t nearly enough. Regulations may help identify the “bad apples” and ensure compliance with minimum requirements. Yet these regulations alone have not been enough to transform a health care system that still harms patients too often, improves too slowly, wastes too much and innovates too little. How do we help hospitals to excel?
Imagine you are a doctor running a clinic in a primarily lower-income neighborhood, where many of your patients are recent immigrants from different parts of the world. You are granted a fixed annual budget of $100,000 through your local public health department, and it is unlikely that you can obtain additional funding later in the year. Traditionally, you have used your entire budget for the past several years, which usually lasts from January until December. This allows you to care for all of the few thousand patients who come to you for treatment throughout the year.
Most everyone is talking about Healthcare lately and I just can’t take it anymore and had to send out a primer, because there is so much bad information being floated. I don’t like the ACA replacement because the idea is still based on the premise that you can give-away insurance as an entitlement program. The problem is that you can’t “give-away” insurance, it’s an oxymoron, if there is no skin in the game for the insured they’ll never care.
If you carve a huge chunk of revenue out of Obamacare and shift more subsidies to the middle class it should not be a surprise that the lower income folks will pay the price
