Over the past few years, Paul has emerged as an authority figure on transparency in healthcare if for no other reason than so few other people within our industry are actually doing it right, if at all. He shared with us the story of how his hospital has embraced transparency not because it was a great marketing tool, or because of the public's demand to know, but rather as a practice to hold themselves accountable for the care they deliver to their patients and community. In his presentation, it was noted that hospitals are now the fourth largest public health hazard in the United States, yet despite that fact, so many still have yet to embrace the best practices available to us and publicly discuss our shortcomings so we might learn from our mistakes. We also discussed the general culture of the healthcare industry and the reluctance there seems to be about aggressively embracing the changes that would lead to significant improvement in patient safety and quality.
In reflecting on this conversation it seems to me that competition and fear have actually become our core competency and focus in healthcare, and the question is at what expense? In the quest for attracting more patients and physicians, we are constantly promoting all of the good things we do while trying to hide our areas of imperfection. As medical professionals we are trained not to make mistakes which makes admitting them that much harder. So while transparency has certainly become a buzz-word in healthcare as of late, if we took a hard look at ourselves, I would have to admit that we have only really been translucent at best.
In just the past couple of months we have experienced both a surgery "never event" and "near miss" related to two issues which we consider to be the most sacred "Red Rules" within our hospital (Active Time Outs and Positive Patient Identification). Surely this is not the type of recognition we want to attract at the hospital, but at the same time if we do not acknowledge the fact that these events happened, I not only fear, but know that we will be at risk of something similar happening again. In both of these instances, we were fortunate to have had positive outcomes for the patients involved, but I feel strongly that we must take the time to learn from these events to ensure that future patients in our care do not encounter these same mistakes.
In talks throughout the hospital, I think most of us are embarrassed by these incidents and may be in disbelief that this could have happened on our campus. From what I've learned, I can assure you that we are certainly not the only hospital that has made such a mistake, but we are among the few who are brave enough to admit it. By openly acknowledging and understanding what has occurred, we will be better able to create processes that will strengthen the hospital and protect our patients from future harm. I'm also counting on the fact that it will help us to re-focus on what is most important, the safety and well-being of our patients.
Still, many fear what might happen if someone outside the hospital found out about these events. People worry that if discovered, our competition and critics will undoubtedly try to use these events to disparage our organization or raise doubt about the quality for which our institution has been known. To that I say, we "call." We've shown our cards, now let's see yours. While its difficult to admit when your not perfect, I'm confident that our patients will both gain trust in us and reap the benefits of our transparency in the long term.
Thanks Paul for the continued inspiration and encouragement to do the right thing. It was my pleasure to have finally met you!
6 comments:
With regards to transparency, I'm curious if you have any thoughts on the recent ruling by Rhode Island's Dept. of Health that requires video cameras be installed in all Rhode Island Hospital operating rooms to monitor patient safety during surgical procedures?
Thank you.
Mr. Bonick, Peacoks are fun and so beautiful but not appropiate in our fun house.
I was recently approached by another facility in a recruitment attempt, being always on the lookout, I did follow through with the interview and was very surprised.
Our near misses and absolute screw up is well known by other large facilities; we are an ongoing joke about our "save one dollar per day per patient" campaign, and the most suprising was the recruiter stated, "we have interviewed 14 experienced nurses in the past 3 months and 9 of them have left Jewish."
Mr. Bonick I know from experience how short staffed we are at the bedside, we have units closed, we have so much overtime it is ethically and sometimes leagally unsafe. We no longer have the time to "care" for or about our patients and it just floored me that so many years of experience are leaving. There is NO retention efforts at JHSMH, none---don't let the door hit you on the way out seems to be the mindset. A revolving door on human resources would be appropiate.
I know alot of the bedside staff that have left or been terminated for some infraction of some policy someone decided to follow on some team member on an unlucky day. All of our policies are so bougus; everything from dress code to attendance to time out for procedures. Putting it on paper does not make a policy, it must be practiced every day, the same treatment for all.
Another funny thing being said among team members is reference to the "Stepford Managers" referring to new nurse managers and VP's of nursing. "They must be compliant with cooprate to keep their job and too dumb to know any better."
Many times I have seen documented cost of orientation of new nursing staff, but you have to get those pepole in the building first. All the experienced staff are going elsewhere, we are known as the place for new inexperienced grads to apply. "You just need a pulse to work at Jewish". It pisses me off when JHSMH is the butt of jokes in-house as well as the healthcare community. When this facility is made fun of so am I. It is enough to make you want to leave.
Thanks for reading this, which will be submitted anonymously because frankly I don't think anyone here cares one bit about the bedside staff and in that truth; cannot care about our patients. As we are in the news yet again for another illegal and unethical issue it makes it harder and harder to be proud to work at JHSMH. Maybe time for me to go as well. If you cannot have pride in what you do day to day, the struggle becomes too much.
Wonderfully said -- wise and true. No human being is perfect, no organization is perfect. Only through our seeing clearly and honestly can we identify our failures and weaknesses and make the necessary changes in our actions.
Remember when we had time to think about patients--now all our thoughts have to be misdirected to gimmicks and paperwork that obviously don't work. But at least management can comfort themselves that they had a policy to hide behind!!! What a pity that a once proud and responsible institution had been allowed to slowly die. We should all be ashamed.
Anon 7:07AM
I appreciate your thoughtful comments and am gathering some information to speak to your issues. Will be writing back soon, stay tuned!
Anon 4:20AM
I am not looking for anything to hide behind, be it a policy or an "annonymous" blog comment. The reason I started this blog was to provide another forum for us to have a conversation and to mutually share ideas and thoughts on how we can improve our hospital. If you think that our actions are not working, I'd welcome your constructive thoughts on what we could or should be doing differently. Being proud of our institution begins with people taking pride in their work. If you don't feel that way, what do you think we should do about it?
Post a Comment