Review of "The State of Patient Experience" podcast and healthcare quality standards

Podcast Review: The State of Patient Experience Although the United States has some of the most highly-respected healthcare institutions on an individual basis within its borders, high-quality care is lacking in many critical areas. While individual healthcare institutions may not be able to remedy this fact on a national basis, hospitals can seek ways to improve the patient experience, both in terms of safety and also empower individual patients to exercise greater autonomy and oversight in their choices when navigating the healthcare environment.

Standardization and Prioritization of Patient Care Healthcare is a lucrative for-profit business in the United States but it is also a business that can mean life and death to consumers. Ensuring that patients receive high-quality care is essential for patients and their families on a human, ethical basis, but also for healthcare institutions to remain solvent. As noted in the 2016 podcast “The State of Patient Experience,” institutions in the competitive capitalist marketplace of healthcare are attempting to leverage safety and quality to gain an edge over other hospitals to attract patients and the support of organizations that provide funding.
Jim Merlino, president and chief medical officer of the Strategic Consulting division of Press Ganey has pointed out that while patients might hope that all institutions meet certain quality standards, this cannot be taken for granted—every year approximately 440,000 deaths in the United States occur in hospitals needlessly, due to medical errors. While risks are highest for senior citizens, risks are present for all patients. Risks do not only occur in areas such as surgery or medication errors but also due to hospital-acquired infections. The essential components of marketing are always product, place, price, and promotion, according to Ganey and if the product in healthcare is care, then at a minimum keeping patients alive is the most basic requirement; some institutions have tragically failed to do so.
Of course, patients and providers alike expect more than simply sustaining patient life but also demand optimizing care. This demands the leadership, according to Ganey, setting standards at the very top to exceed current industry benchmarks and creating a plan to do so. Safety must be discussed, as well as the consequences of not following safety standards, and violators must be punished. But while Ganey talks a great deal about setting standards by leaders in the hospital’s executive suite, all members of the organization must be equally invested in the care and quality improvement. This means investing in the training of providers to ensure they follow the most recent and best standard operating procedures. It also means keeping track of what is working for the institution, what can be improved, and also keeping abreast of current technology and evidence-based medicine.
What was the industry standard in the past may not be the case in the future. Technology and knowledge is constantly changing and evolving, and educating providers and investing them with a sense of urgency about standardizing and improving standard operating procedures to ensure patients are cared for appropriately is essential. Knowledge of high-risk patients in the context of certain disorders and conditions is also important—for example, patients who are elderly may be at higher risk for acquiring a hospital-based illness, while certain historically underrepresented groups may have a higher diabetes risk. Transparency in Healthcare One of the most frequent complaints about healthcare institutions is that patients lack the ability to make informed choices, based on a lack of information. In contrast to other important big-ticket purchasing decisions, patients are not given information upfront about how much a procedure will cost. It is also extremely difficult for patients to compare ratings and safety records of physicians, particularly given that patients are often laypersons who do not always understand the full implications of medical data; they are reliant upon secondary sources to make such information digestible and understandable. According to the podcast, institutions have a role in informing patients about such issues. Additionally, this can be a source of added value to institutions with high physician ratings and strong safety records, as it can build patient confidence, encourage patients to select the institution, and generate goodwill in other areas to draw funding and support. There are independent rating organization the Leapfrog group, offers evidence-based ratings of hospitals on a variety of benchmarks, including patient safety, outcomes of patient care, and overall healthcare grades and scores.
Of course, the problem arises when the institution is struggling with a particular quality marker and may wish to conceal such information. Patients may notice a red flag regarding the absence of such data, but because of a limited selection of providers via their health insurance organization, they may not necessarily be able to switch their allegiance from one institution to another with any great ease. Some requirements regarding public reporting via the government is likely to be needed to ensure that complete, easily comparable data is offered to the public. Finally, it is also important to note regarding transparency that in emergency situations, rural contexts, and other areas, patients may still have little choice, even if the institution is fully transparent about deficits in quality.
Transparency thus acts as an important mechanism regarding accountability, but it is not enough. Also, transparency alone from a healthcare institution, even a good one, may not necessarily result in more patients depending on patient insurance, and the type of care offered. While higher quality and safer surgeries and high-risk procedures that patients are more apt to research may benefit providers providing such critical care, this may be less so with primary or emergency care. The Internet has made it easier for patients to conduct research than before, but interpreting the information and evaluating the quality of such information is more challenging. Advances in Healthcare Reform Healthcare reform has clearly brought about greater democracy to the healthcare system, increasing the number of individuals insured through the provisions of the Affordable Care Act (ACA)’s government subsidies (French, et al., 2016). Increasing the number of insured individuals should result in less dependency on emergency rooms as sources of care. Better primary care will hopefully, over time, result in improved health and lower costs overall to the healthcare system. The ACA also instituted measures for expanding electronic health record-keeping, which ensures greater comprehensiveness of data on patients, and the ability for patient records to follow patients across multiple providers. For patients who lacked insurance, paid more for insurance, and were under-insured before, the ACA has been highly beneficial. It has offered greater security for patients with preexisting conditions, due to is prohibition against discrimination for this reason, and enabled young people to remain on their parent’s insurance for longer periods of time, thus reducing the risk that people starting their careers will lack care during their years beginning their occupations (French, et al., 2016).