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researchtroubles's avatar

Hospital Quality?

Asked by researchtroubles (7points) October 16th, 2017

When can you say that a hospital is delivering health care in a manner which maximizes resource use and avoids waste?

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6 Answers

elbanditoroso's avatar

You need to look at their outcomes and their budgets. Otherwise you have now basis on which to make the judgment.

CWOTUS's avatar

Welcome to Fluther.

Probably the most effective and reasonable way to do this is to compare “this hospital” against its peers in the region (because acceptable cultural norms may vary greatly from one region to another, so it’s not fair to a first class operation serving a wide range of patients to compare it to, say, a small urgent-care hospital in a rural area, which serves primarily simple needs). So: benchmarking.

But on the other hand, don’t completely overlook those tiny hospitals in rural and third world areas, either. See how they manage to deliver quality health care and results on shoestring budgets, and learn and adapt what can be adapted to a more industrialized situation.

But as @elbanditoroso has noted, “maximizing resource use and avoiding waste” comes down to careful scrutinizing and management of the budget vs. the year-over-year outcomes, and doing that rigorously and continually.

In this way you’d be doing two things: comparing your outcomes against your peers and working to deliver “results as good as the best” (if not actually “being” the best, that is), while at the same time justifying every expenditure and demonstrating that improvement in outcome and finances from year to year.

Mariah's avatar

Best hospital experience I ever had was at the Cleveland Clinic. They had technology for their IV pumps that alerted nurses wirelessly if there was an issue rather than beeping to get their attention, so I could sleep. They also had beautiful art and musical exhibits that I was able to peruse once I was well enough to leave my bed. It was much more pleasant than many other places I’ve stayed. I left them with a very positive impression.

However, in my reading this year, I’ve learned that all that fancy stuff is a sign of something a little darker for hospitals.

Hospitals build their beautiful marble lobbies and shit like that not because they think it’s going to help any patients, because obviously it won’t, but because they’re approaching the end of the fiscal year and they see “oops, we made a profit this year.” A majority of hospitals claim not-for-profit status to reap tax benefits. When they see they’re going to make a profit, they spend the money quick to zero out their budget. A fancy lobby is an indication that a hospital overcharged its patients.

A hospital that avoids waste will look plain.

snowberry's avatar

I’ve noticed the same thing about the fancy lobbies, etc.

I am in the US. For most hospitals here, for profit or not, balancing the budget is always very challenging.

My father landed in the hospital due to a stroke. He came out with C-Diff (Clostridium difficile). He had extreme diarrhea, and every time he stood up the stuff just fell out of him onto the floor. I was appalled to see that nobody cleaned it up.

When I asked about it, the staff told me that hospital policy dictated only the janitorial staff could clean (as in do janitorial work such as cleaning up diarrhea in a patient’s room). And then I learned that the janitorial staff was limited especially at night to save costs.

I watched repeatedly as nurses and techs walked in and out of his room right through the mess. I finally started gathering linens, towels, whatever I could find to mop it up. I used lots of soap from the dispensary in his bathroom, and did the best I could. I’m very thankful I didn’t get it too, because C-Diff is very infectious.

It’s easy to see how he got this infection at the hospital. This was 20 years ago!

My daughter works nights as an RN on a MedSurg floor in a hospital, and she sees the same kind of problems there. Patients that are unsteady on their feet are not allowed to get out of bed unassisted. This means that someone always must be available to help them shower or go to the toilet. However, to cut costs, the administration has limited the number of available staff at night. I could not count the number of times she has told me how a patient had fallen or nearly been injured because of lack of staff to take them to the bathroom at night! Oh and if somebody falls, is injured, or dies, it’s her fault. Smart thinking on the part of the administration, don’t you think?

Medical costs in this country are already so high it’s a very difficult choice to think about going to a doctor let alone the hospital. Hiring more people to make hospitals safer would only drive the costs even higher. It sounds like a lose- lose proposition to me.

elbanditoroso's avatar

I’m going to take the entire opposite view as @snowberry .

I was in the hospital for about 9 days in September – bad infection that got worse.

The hospital was superb. Medical care was excellent. Infectious disease specialists came daily, RNs visited frequently to see how I was doing. LPN and techs were there when I needed them. The place was a little old (not the latest fanciest electronics), but the care I received was just excellent.

Sure, I understand that not all hospitals are managed well, and that there are bad outcomes.

But for my own very recent experience, I was thoroughly impressed. I was taken care of well. And (the best news) – I am 99% healed.

kritiper's avatar

When you have been admitted, and everything seems on the up-and-up, and the general staff and their treatments don’t scare you into thinking you’ve entered an insane asylum.

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