Hospitals Do a Poor Job of Reporting Problems

Complete and accurate data about performance are essential to any improvement effort. You cannot measure whether performance has improved unless you know what it was when you began, and what it is after improvements are made. That is true in every industry, including healthcare.

So I find it disturbing that some major healthcare institutions have questionable data about their performance.

According to The New York Times, the office of the New York City comptroller developed a report saying the city’s hospitals are the least reliable in the state at reporting preventable mistakes and adverse incidents for patients like heart attacks, blood clots, hospital infections and medication errors.

Though city hospitals accounted for almost half the patients statewide in 2006, they reported about 39 adverse incidents per 10,000 patient discharges, compared with nearly 70 per 10,000 in the northern suburbs and upstate and nearly 64 per 10,000 on Long Island…

Particularly since similar institutions are being compared, the report said, a higher number of incidents does not mean that a hospital provides worse treatment, only that it is more diligent about reporting problems. The lack of accurate reporting makes it virtually impossible for consumers to judge accurately the quality of a hospital or for the hospital to compare itself with its peers and make improvements, the comptroller’s office argues, saying the consequences include longer hospital stays and higher health-care costs.

“Without the fullest possible reporting, hospitals cannot identify areas where systematic improvement may be needed,” reads the report. “Weak enforcement and flagging commitment to a broad-based effort has compromised the whole program.”

A variety of hospital officials have questioned the validity of the report. But even if they have some legitimate points, the Times article, written by Anemona Hartocollis, notes that “a hospital’s size and the type of procedures it performs do not seem to explain the differences in reporting rates.”

This is an aspect of lean initiatives that doesn’t get talked about very often – the fact that improvements in data gathering and reporting may be required before actual process improvement takes place.

What is the worst data problem you’ve encountered related to improvement efforts?