Healthcare Issues To Focus On
As health care reform sets in, industry leaders are looking for hot spots that might indicate ongoing problems. At the recent American College of Healthcare Executives Congress, one conversation focused on three health care management issues capable of derailing a facility and affecting patient outcomes.
With superbugs escalating around the world, healthcare-associated infection, or HAI, prevention is at the top of the list. In 2011, there were around 722,000 HAIs reported in acute care facilities in the U.S. They came with an annual price tag of over 9.8 billion dollars, according to Leslie Mandel, a researcher at Regis College School of Nursing and Health Sciences.
The current view is that most HAIs are preventable by addressing practices in key patient areas like intensive care and the emergency room. Mandel claims few hospitals have a dedicated strategy in place to eradicate HAIs in the ER.
To get an idea of what works in this environment, she visited 14 facilities who do it right and conducted interviews. She found:
- Departmental or institutional factors were the key motivators for staff, not regulatory compliance.
- These facilities used data to demonstrate infection rates within the department.
- Departments need a management champion who focuses on infection rates.
Staff must feel accountable not only for HAI rates but for patient health and outcomes, as well. The organization must consist of a culture that takes patient quality of care personally. If one member of staff fails to adhere to hand-washing hygiene standards, it is everyone’s problem. Eradicating HAI needs to be a hospital-wide effort designed to improve the quality of patient care.
The Problem with Autonomy
The conference looked at the negative effect work autonomy has on health care, as well. Healthcare reform is based on a coordination of care model, one that works against the autonomy many doctors and nurses crave. Team-based care practices are the new standard in the industry, but it may impact employee motivation and care quality.
David Dobrzykowski with Rutgers University and his colleagues interviewed hundreds of hospitals looking closer at how autonomy affects work practices in a clinical setting. He drew these conclusions:
- To motivate staff, the administration must engage with them.
- Patient care and attitudes improve when the staff is motivated.
- A certain amount of autonomy does have a place in improving patient satisfaction. However, patient satisfaction is not the driving force for net income.
- Even though autonomy is sometimes a positive way to encourage staff, ultimately, it diminishes teamwork.
- Teaching hospitals may have a different take on this subject.
The goal of any hospital should be improving Hospital Consumer Assessment of Healthcare Providers and Systems, HCAHPS, scores. Staff motivation does that, so facilities can spend less time worrying about creating cozy environments and focus on staff engagement.
The third main topic addressed by the congress was price transparency. This problem affects both hospital management and patients, but it is a difficult nut to crack because user interfaces vary so greatly. One approach might be to standardize and centralize information for patients. More research is needed on the subject, however; to develop actionable solutions.