By Jane A. Malkoff MSN RN NP
653 residents were sampled from 600 nursing facilities in the United States and one-third of them were at the receiving end of medication errors, 59% of which were preventable. Safety in the health care system is a national issue. Indiana is at the bottom of the list for quality services provided to seniors. Poor outcomes are rampant due to infections, substandard care, delay in care, or failure to provide care.
Here is an excerpt from an article that may shed some light on the situation;
“Over the last 30 years, there have been amazing advances in our abilities to combat human disease and equally impressive innovation within information technology that has changed the way we live, yet there has been staggeringly little application of innovation to the efficiency of our healthcare system. No one should be surprised by this situation. Healthcare in America is provided, and paid for, by the transaction – per office visit, per surgery, per x-ray – with little visibility into performance, efficiency, quality or cost. We pay for volume and, as in any industry, people who are paid by the widget will seek to produce more widgets at ever increasing prices. Why has it worked this way? It is easier to measure transactions than outcomes. Bryan Roberts, a PhD and partner at Venrock, 2011.
With health care legislation headlining daily, it is hard to sort rhetoric from reality. It is important individual consumers know what to do. What follows is a true story (name changed) to help you begin to think about the questions, 1) Are You a Widget? and 2) What Can You Do as a Consumer?
After a recent hospital stay, Gloria discharged to a nursing facility in a suburb north of Indianapolis. Gloria was weak and decided to take advantage of her Medicare benefit for rehabilitation. She had no cognitive impairment. After a short time adjusting to the difference between care received in hospital compared to a rehabilitation facility, Gloria noted there was a sudden major difference in her medications. She asked the nurses what all the pills were. They couldn’t tell her but tried to convince her to take them anyway by stating, “They are your pills the doctor has ordered for you”. She asked about the blood pressure pill she had taken for 15 years and why it was missing. Again, made to feel incompetent or as if thinking poorly, she was urged on about her need to take the pills. Her voice rose as she became concerned. She told them they ought to know what the medications were they were offering her. She was told to lower her voice. One nurse told her the medication changes were due to end stage renal failure. Gloria was unaware she had end stage renal disease. She asked to speak with the Director of Nursing. This was denied due to the person being on a leave. She asked to speak to the physician. When the physician came the next day he told Gloria there had been a mistake. A blood test had been taken from the gentleman in the room next to her, mislabeled as hers, results were reported to the physician as her results, and medications were changed incorrectly as a result. There were no apologies made to her. Gloria made some calls, got herself into a wheelchair, and discharged herself to home to sort out her needs in a safer environment.
In the next two blogs we will delve further into how to be a savvy consumer versus a widget.