Becker's Hospital Review

37 QUALITY IMPROVEMENT & MEASUREMENT Viewpoint: A high- quality physician has more than good metrics By Mackenzie Bean B eing a high-quality physician is about so much more than having a board certifica- tion or working for a well-known health system, two clinicians wrote in a Dec. 3 op-ed published in JAMA. Alok Khorana, MD, an oncologist at Cleveland Clinic, and his wife Melissa Khorana, RN, executive director of e Arc of Greater Cleveland, came to this realization aer going through a seven-year healthcare journey with their son Matthew, who has Down syndrome. At age 17, Matthew became irritable and physically aggressive. He also experienced intermittent bouts of abdominal pain, nausea and vomiting. Matthew underwent numerous endoscopies and evaluations from seven different specialists, but no one could diagnose him. It wasn't until seven years later that Matthew got an actual diagnosis when his family moved to a new town. Instead of taking Matthew to a physician at one of the two nationally ranked health systems in their community, Dr. and Ms. Khorana asked the parents of other children with intellectual disabilities for recommendations. Aer about a 15-minute evaluation, Matthew's new primary care physician identified celiac disease as a potential diagnosis, which was confirmed several days later. "What allowed Matthew's doctor to identify the diagnosis that so many others had missed? Certainly, she was compassionate and well- trained, but so were the prior clinicians," Matthew's parents wrote. What made her stand out was that she cared about people with intellectual disabilities and took the time to review the few studies available on gastrointestinal and mood disorders in Down syndrome. e healthcare industry places such a huge emphasis on quality measures, but at the end of the day, the best physician is the one who can make your loved one feel better, Dr. and Ms. Khorana concluded. n VA discontinues star ratings system for hospitals By Anuja Vaidya T he U.S. Department of Veteran Affairs has discontinued its star rat- ings system in an effort to improve transparency and allow veterans seeking healthcare to more easily compare VA and non-VA facilities. The star ratings system, developed as an internal tool, enabled veterans to compare quality and performance at VA facilities. But the ratings did not "provide insight as to how our hospitals stack up against nearby non-VA facilities and are therefore of little value in helping veterans make informed healthcare decisions," VA Secretary Robert Wilk- ie said in a news release. Instead, each VA hospital's website now features links to tools that will allow users to compare wait times, quality of medical care and patient experience ratings at facilities in their local area. The VA will, however, continue to publicly release its Strategic Analytics for Improvement and Learning data that is used to internally manage hospital performance within the VA's health system. SAIL data assesses 60 quality metrics, overall efficiency and physician capacity. n Viewpoint: To reduce medical errors, bring in outside experts By Gabrielle Masson A bout 40 percent of primary and outpatient care patients are harmed by medical errors worldwide, according to a Septem- ber 2019 report from the World Health Organization. This rate could be lowered if the healthcare industry identified the root causes of these errors and allowed others to lead — not just medical professionals, Kathleen Sutcliffe, PhD, a professor of medicine and business at Balti- more-based Johns Hopkins University, wrote in an op-ed for Time. Medical professionals' refusal to allow for expertise and innovation from other professions is to blame for the lack of improvement in medical error rates, according to Dr. Sutcliffe. She added that patient safety was taken over by healthcare administrators who typically blame those further down the organizational ladder for errors, instead of examining inherent flaws in the organization and system. Dr. Sutcliffe calls efforts like safety checklists and hand-sanitizing stations localized and weak. Organizations need innovations aimed at addressing larger hazards tied to confusion and error-inducing technology, accord- ing to Dr. Sutcliffe. Healthcare organizations should approach patient safety with a focus on what lessons can be learned from successes, instead of failures or mistakes, Dr. Sutcliffe wrote. Medical errors have multiple root causes and require multidisciplinary approaches to find solutions. Experts with perspectives outside of med- icine should be welcomed to any serious discussion on how to improve patient safety, according to Dr. Sutcliffe. n

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