Saturday, May 17, 2014

A fictional story: Counterpoint and extension

File:Guantanamo captive's hospital beds -c.jpgToday we welcome our first guest blogger, Dave Bridgelend, a mathematical modeler who focuses on business modeling and simulation. Dave has created business models for government agencies, financial services companies, telecommunications companies, energy companies, and healthcare organizations. He is the co-author of the book "Business modeling: A practical guide to realizing business value".
David Hartley recently described an attempt to reduce hospital acquired infections at the (fictional) Generic General Hospital. The attempt seemed successful, until the hospital CEO considered the broader impact of the effort. The budget for routine HAI prevention activities was raided to fund the improvement, and that budget diversion would likely cause unintended consequences.

But there is a bit more to this story. After the GGH CEO lectured her staff on unintended consequences, the GGH patient advocate spoke up. She pointed out that GGH already scored well on the HCAHPS measures of hospital acquired infections, earning ratings of "Better than the US national benchmark" on CAUTI and MRSA, and ratings of "No different form the US national benchmark" on the other four HAI measures.

"And when patients choose a hospital, they look at HAI a bit, but most of their decision is driven by what they hear from their personal networks. Last year when Martha was in the hospital for a week, the hospital made a big stink about her daughter staying in the room with her.  When Joe broke his leg, the hospital was too loud at night for him to sleep. When Carol had her hip replaced, she said the bathroom was dirty."

She continued: "I understand we want to improve GGH. But let's focus our attention on what the patients care about. Further reducing HAI won't bring them here. Keeping the bathrooms clean will."
(image source: Wikipedia)

1 comment:

  1. Dave makes an excellent point in his guest blog: Patients care about infection prevention, yes, but also other things like quality of the total hospital experience. While many researchers and healthcare providers are strongly focused on how to protect patients from infection during stays, and appropriately so, patients are often focused on other issues. All perspectives are important for the business decisions hospitals make. Thanks Dave for making this point.