The section on Quality addresses one of the most important lessons for Administrators….don’t always trust your reports. Dr. Pinney highlights the problem in his example with the Pre-Operative Surgical Checklist.
According to the Administrator, the checklist was preformed consistently for two years without issue. The problem was that it wasn’t performed correctly. Significant errors resulted and were unreported.
One of the most important lessons that I have learned from working closely with Medical Directors is that they know the business. When they say something is wrong, something is likely wrong. Administrators need to dig into the details to get to the bottom of the issue rather than dismissing them.
Interestingly, Dr. Pinney and I have uncovered the same issue. Data is often missing and when data is missing – the reports are wrong. Administrators need to understand why the data is missing and take the steps needed to ensure it is consistently captured. It’s a matter of life and limb – literally.
According to Dr. Pinney, these types of quality and process improvements are key to systematizing medicine and achieving the third aim. However, it all starts with accurate data.