When choosing a hospital how do you qualify it? Word of mouth works, insurance companies generally don’t give you a choice, or you’re going for a specific department rather than the overall hospital. Yet, even specific highly regarded departments share support staff from departments that may not be so reputable.
Is there a national ranking standard? No, not really. Why? Hearst Newspapers recently answered that question during their investigation that found that state and federal governments collect a treasure trove of safety information. Unfortunately, they don’t allow the public to see it.
This information doesn’t have specific patient information. It also doesn’t violate any other privacy laws if it were compiled and released. So why not release it? The short answer is healthcare cost, insurance premiums, and medical malpractice insurance premiums and lawsuits.
The Investigation
Hearst Newspapers and Niagara Health Quality Coalition of New York analyzed publicly available data in four states for 2007, the last year available to them. They identified the hospitals with the best and worst safety indicators. They found through their analysis that it was a service the federal government could do itself.
This is a clear indication of the dismal state of the federal medical error reporting methods. The frequency of errors was underlined in a report issued in early March by the Inspector General of the federal Department of Health and Human Services.
If the report is any indication of the general practices of hospitals around the country then that means hospitals aren’t tracking their adverse events internally let alone reporting them publicly. The Inspector General investigated 278 hospitalizations in two undisclosed counties. It uncovered 120 problematic “events” in which patients were harmed either permanently or temporarily. Yet the hospitals in the federal investigation had only done incidents reports on 8 of the 120 cases. They even missed two of three cases where patients were killed, the report stated.
This revelation may come as a shock to many. Yet, it may be indicative of a systemic problem where each department’s funding is based on results and could be severely cut if they comprehensively report permanent and fatal mistakes.
Systemic Problem
It’s pretty obvious that members of Congress have been fully aware of this problem, but have, by-in-large, avoided enacting meaningful change. Federal agencies have taken baby steps, and the states, left to decide how data is disseminated and distributed, have created a system fragmented and chaotic bureaucracy.
Hospitals themselves and the health care industry have resisted public reporting of medical errors. Healthcare lobbyists are some of the most financially aggressive in Congress than any other industry to the tune of $500 million a year. It’s unclear how much of that money was related to error reporting, but as much as the tort reform issue has been on the lips of politicians, the reporting of errors will be just as important since they are so closely tied.
Not to be too critical. Hospitals certainly use the safety data privately to make improvements. They are critical of public reports that inevitably put underperforming hospitals at a disadvantage and prone to medical malpractice lawsuits.
The Agency for Healthcare Research and Quality (AHRQ), an arm of the U.S. Department of Health and Human Services, is in charge of collecting records of errors from 41 states. When it collects the data, instead of compiling it into a single report that would benefit patients, it uses the data for merely state-level compilations, which provide no hospital-specific information for the consumer.
Lisa McGiffert, director of Consumer Union’s Safe Patient Campaign, said tantamount to Consumer Reports refusing to name the best and worst cars in America. They requested the AHRQ data under the Freedom of Information Act and the agency flatly refused.
The Consumer Union is a nonprofit focusing on patient safety whom has urged citizens to send a letter to the president regarding this issue. In it they cite a study published in The National Academies Press called, “To Err Is Human”. It is a comprehensive study conducted in 1999 documenting the epidemic of medical errors plaguing the U.S. health care system and suggested methods to make patients safer.
The study remains relevant since nothing has changed. To put this into perspective, hospitals have existed in the United States for 300 years. The Department of Health and Human Services has existed for 57 years and hospitals are still hiding essential information that could aid patients in determining their personal care. Pathetic.
UW Medical Finds out Federal Ranking and Internet Ranking are Different Animals
Recently US News and World Report made a gallant attempt to rank 900 hospitals based on their cancer care departments only. Some of the household names in hospitals were on the list, Mayo Clinic, Johns Hopkins, and Mass General. Much to UW Medical Center’s delight they popped up at #7 on the list. Needless to say, they were giddy.
But the Hearst investigation burst their bubble. By using public disclosure, Hearst was able to get medical error information from four states, New York, Texas, California and Washington State from as early as 2002. The administrative data (billing or discharge data) contains information on the condition and treatment outcome of every patient. The records did not include patient identities.
Using that information the NHQC applied AHRQ’s quality and safety measures to billing data to create unranked report cards on New York hospitals. But for the first time, NHQC identified the top and bottom hospitals in two states, New York and Washington.
Several hospitals that made the Top 20 list of hospitals published by U.S. News and World report scored poorly in the NHQC study. They include Mt. Sinai Hospital in New York and sadly the University of Washington Medical Center.
Dr. Gene Peterson, associate medical director at the Seattle hospital, didn’t dispute the data. He was familiar with it, but said that, as one of the largest teaching hospitals in the country, they treat some of the sickest patients. He pointed out that in some cases the data might be misleading because of inconsistent reporting of the condition of patients on admission. He said patient safety is “our overwhelming strategy.”
Though there is no question that hospitals do not deliberately aim to hurt or kill patients, but without reporting it is impossible for the public to know if their furthering injury or loved one’s death was avoidable due to the direct procedural policy of the hospital for cost cutting reasons. Many patients die from infections directly linked to these policies.
Last year Hearst reporters did another data analysis of medical errors titled Dead By Mistake. That project revealed the neglect to address medical errors and hospital-acquired infections, which are blamed for 200,000 annual deaths, the number one cause of accidental fatalities.
Many people feel as if they are safe when the finally get to hospital, but there are many other factors working against them and sometimes they aren’t just related to their injury or illness. There is a system of profit that filters through every level of healthcare and dictates the policies that can drastically affect a patient’s care.
The profit machine is the crux of the reporting problem. There is no healthcare police and politicians have clearly shown that they are on the side of two of the largest lobbies on Capitol Hill, Medicine and Insurance. The only protection a patient has to protect themselves and hold the healthcare institution accountable is to use litigation.
If you or a loved one have been severely injured or killed by suspected medical malpractice then it is important that you find experienced council that can clearly explain your rights and represent you in your fight to protect those rights. Call Phillips Webster for a consultation on your legal options.
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“Tort reform” is a fancy term that opponents of medical malpractice lawsuits use to confuse people while stripping them of the right to seek compensation for a severe medical errors. Opponents tell people that medical malpractice lawsuits are to blame for everything from skyrocketing healthcare costs to unscrupulously high medical malpractice insurance premiums, but yet, the number of malpractice lawsuits and the amount paid out to them had changed very little if at all over since the 1980s.
