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Tuesday, June 17 2014
1:00 PM - 3:00 PM EDT

The Building Blocks for Population Health Management: Real-Time Clinical Surveillance and Clinical Performance Benchmarking

Fiona McNaughton, Dir. Product Management, Truven Health AnalyticsPresenter: Fiona McNaughton, Dir. Product Management,
Truven Health Analytics

Registration URL:
https://attendee.gotowebinar.com/register/2723592914253652482

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What Early CG-CAHPS Results and Data Are Telling Us

What Early CG-CAHPS Results and Data Are Telling UsHealthStream, leading patient survey vendor for over 750 hospitals, has collected a large sample of CG-CAHPS survey results from physician offices over the last three years. The survey data identifies clear trends in how patients perceive the care they are receiving from their providers. Specifically, the data illustrates that how well a provider communicates in the exam room has ramifications on the patient’s overall impression of the practice.

Because national CG-CAHPS scores are trending on a tight curve like HCAHPS, providers will need to receive high marks on surveys just to reach the average at the 50th percentile, nationally. It’s time for all providers to develop a patient experience strategy.

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By William A. Hyman

It has been popular to compare aviation’s safety record and procedures to similar processes in healthcare, usually with the notion that healthcare lags aviation in adopting a firm safety-oriented methodology (Carr, 2006; Pronovost et al., 2009; AHA, 2011). There can be considerable challenges when making such cross-discipline comparisons including staffing, training, mission scope, and perhaps personal risk.

It has been popular to compare aviation’s safety record and procedures to similar processes in healthcare, usually with the notion that healthcare lags aviation in adopting a firm safety-oriented methodology (Carr, 2006; Pronovost et al., 2009; AHA, 2011). There can be considerable challenges when making such cross-discipline comparisons including staffing, training, mission scope, and perhaps personal risk. If these challenges are not adequately met, the lessons supposedly learned may not actually be transferable from one profession to another. Or worse, thinking that they are readily transferable may lead to a false sense of accomplishment when one or more safety “fixes” are implemented.

One aspect of the aviation-versus-healthcare comparison that has not received sufficient attention is a direct comparison of the task structures and responsibilities of pilots versus nurses. As shown in the table below, there are very substantial differences between the work and work environment of each. Further, these differences appear to be put nursing at a considerable disadvantage with respect to being able to consistently accomplish their work without identified adverse incidents. Thus the relative deficit in healthcare safety compared to aviation is likely a result of major staffing, system and work design issues that is not likely to be adequately addressed without significant effort and change. However this is not an excuse not to do it, rather it is a call for an level of effort that is commensurate with the risk.


Aviation

Nursing

Work is primarily stationery – at the controls


Work is mobile

Primarily a single task – although that task has multiple components


Multiple often relatively unrelated tasks

Dedicated assistant – the co-pilot

Informal assistance when called upon


Standardizes staffing levels – no exceptions


Variable staffing levels, including working even below local standards


Equipment in use configured and certified by a central integrator



Associated substantial system feedback to operator


Independent equipment from multiple vendors



Limited and non-integrated feedback

Tasks highly standardized

Variable tasks depending on patients and other duties


Highly trained and certified on specific equipment



Mandatory refresher and emergency training


Variable training – often on multiple versions of the same devices


Limited refresher and adverse event training

Mandatory near miss (close call) reporting


Extensive

Haphazard reporting


Activity is partly under direct and continuous observation by third party (FAA)


No supervisor/third party observation

Pilot shares physical risk with passengers

Physical risk not shared


Clear outcome expectations – including by public


Possibly variable expected outcomes depending on patients, making it hard to identify untoward outcomes


Extensive external accident investigations

Primarily internal accident investigations – if at all



William Hyman is professor emeritus of biomedical engineering at Texas A&M University. He now lives in New York where he is adjunct professor of biomedical engineering at The Cooper Union. Hyman may be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it. .

References

AHA Resource Center. (2011, April 11). Aviation and patient safety, American Hospital Association. Available at http://aharesourcecenter.wordpress.com/2011/04/11/aviation-and-patient-safety/

Carr, S. (2006). The joy of cross-fertilization. Patient Safety & Quality Healthcare, 3(2). Available at www.psqh.com/marapr06/editorial.html

Pronovost, P. J., Goeschel, C. A., Olsen, K. L., et al. (2009). Reducing health care hazards: Lessons from the commercial aviation safety team. Health Affairs, 28, 479-489.



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