Using data to improve safety, costs

This week we brought you coverage of the 2013 Healthcare Leadership Forum which included thoughts on evidence-based medicine, decision support and patient safety from some of the healthcare industry’s top thoughtleaders.

Also on the docket was Chesley “Sully” Sullenberger, the pilot of US Airways flight 1549, also known as the “Miracle on the Hudson.” After striking a flock of geese less than three minutes into the flight, Sully miraculously landed the Airbus on the Hudson River in New York City. All 155 passengers and crew members survived. Sully’s talk was riveting and he noted he had built his “reputation one interaction, one person, one day at a time. That’s true in each of our lives. In every encounter, there is the opportunity for good, ill or indifference. We have to choose which it’s going to be.”

Healthcare can benefit from those individual encounters too, he said. “Medicine has islands of excellence in a sea of failure,” he said. Preventable deaths are seen as unintended consequences. There is more complexity in medicine than aviation but that doesn’t explain away all the negative outcomes, he said. Medication errors are really system errors. “Bad outcomes are almost never the result of a single incident but are the end result of a causal chain of events,” he said. The 200,000 annual preventable deaths translates to three jetliners crashing every day. “I am an eternal optimist. I believe you will eventually find a way to reduce the number of preventable deaths.”

Other speakers also addressed the problem of patient safety. Adverse events in hospitals may be ten times greater than previously measured, according to research conducted by David C. Classen, MD, MS, CMIO of Pascal Metrics and assistant professor of the department of medicine at the University of Utah.

A report from the Office of the Inspector General found that only 1 percent of adverse events are reported. Voluntary methods underestimate events and concentrate on what is interpreted as being preventable, Classen said.

“The best evidence we have is inpatient focused, particularly on medication safety. Beyond that, the evidence evaporates pretty quickly.” Other industries can help, he said, and the field is a critical area for more research and development.

“Overall, the newest studies of patient safety should not be used to congratulate ourselves on how we’re doing but raise concerns that we haven’t made more improvements.”

On another note, Intermountain Healthcare, a network of 22 hospitals and 185 clinics based in Utah and Idaho, announced it is building a new data system that will track the actual cost of every procedure and piece of equipment used in its system.

In an interview with the Wall Street Journal, Intermountain Chief Quality Officer Brent C. James, MD, explained that eight management engineers measure how much time it takes a technician to set up a lab test, as well as how much glassware and reagent the test consumes to process, and how much time it takes on the analyzing machine. These will be inputted into its data system.

The new data system will cost “several hundred million dollars” but Intermountain expects to recoup that loss within one year if it succeeds in removing waste from the system.

Is your organization working to remove waste from its processes? Please share your experience.

Beth Walsh

Clinical Innovation + Technology editor