Following the public release of Rate My Hospital report last week, I received the following question on twitter: “CBC 5thEstate is being pretty provocative, are hospital CEO’s cringing across the country? Reaction?”
Personally, I welcome the public scrutiny, and support actions that increase the transparency and accountability of our health care system. Ontario has been publicly reporting on multiple quality and safety indicators for a number of years now which has been a very good practice, but the fact is, there has been little if any public reaction to that information. The Rate My Hospital report was different because it was produced by a third party, it was easily accessible, it focused on issues that public are interested in, it compared hospitals right across Canada and, most importantly in my view, it was set up to foster ongoing discussion.
Within the healthcare community, reaction to the CBC report has been mixed. Many have welcomed the spotlight and the tough questions, and are using their results as fuel for ongoing improvement. Others have focused on the methodology shortcomings and are explaining why the grades they got don’t capture the reality of their particular situation. Do I think the five indicators that were used to generate an overall rating tell the full story on hospital performance? No. Did I have concerns about people jumping to conclusions about our hospital without other important data at hand? Yes. Did I like having my hospital rated a ‘C’? No. But I do think that the Rate your hospital type report was a good thing? Yes.
My bet is that notwithstanding the limitations of the report, hospitals across the country are hunkering down to look at their data closely and making sure that they have action plans in place to improve. We certainly are.
I know that people want to make sure that the methodology issues are addressed for next year and are providing feedback on this to CBC. Others are looking beyond the ratings and using this as an opportunity to talk with their staff, community, and media to help explain topics like death rates. I think the report offers us a great opportunity to communicate better about complex hospital issues, and to to build (or in some cases rebuild) trust with our communities and staff.
In my experience I know people don’t expect us to be perfect, but they do expect us to be open, honest, responsive to feedback and committed to excellence. There is a lot of really good work that happens each and every day inside our hospitals and we need to get those stories out as well so that there is good context for reports like these. But at the end of the day, where there is an opportunity to improve, hospitals have a responsibility to take action. Our team at KGH is already well on its way to addressing issues raised in the report, and you can bet on the fact that our ratings will improve next round!
Thank you @Sanjaycherian for sending me this great question. For any out-of-Canada readers, you can check out the report we are referring to here. I welcome your thoughts on how this report compares to those used in the US and UK.
The comments section is closed.
Leslee, too bad the Fifth Estate didn’t look further under the covers at the ongoing antics and arrogance of local hospital administrations, hospital boards, and hospital foundations. With the exception of the 132 hospitals that responded to the survey, the Fifth Estate missed the real story behind the remaining hospitals that refused to respond to the survey. If they dug a little deeper they would have uncovered more serious physical infrastrucuture health and safety issues, misleading ads and communcations by hospital officials, hospital foundation fundraising concerns, personal and political agenda’s of hospital officials and politicians that are not in the publics best interest etc.
Respectfully,
Doug Snedden
I appreciate Leslee’s response. I think every organization needs accountability and that it has been sorely lacking in Canadian hospitals. An organization that is accountable only to the bottom line can become a tragedy. (See Francis report in the NHS http://www.midstaffspublicinquiry.com/)
I have found the public is not as involved as might be expected because people are either healthy or they’ve had no issues with healthcare. They don’t want to think about scary things that might happen if they get sick. People who have had negative experiences or who see opportunities for change are more likely to be interested and engaged.
Leslee Thompson has initiated an remarkable Patient Family Advisory Council at KGH that has been recognized nationally. The members are engaged and committed because they have have experience as patients and because they are respected and listened to by administration. They even took part in the accreditation survey.
I would hope that the PFAC would share Leslee’s concerns about “their” hospital’s rating and take up the challenge of collaborating for improvement. I think such a response would be public healthcare at its best.
These hospital revelation stories:
…….. should include the ppt by /Mark Romoff entitled: Addressing Canada’s InfrastructureChallenge – The Demand for Innovation:
Romoff thinks P3 means Public /Private Partnerships.
However………IT actually means ( public/private/voluntary sector partnerships)
( check the just published Social Finance report. Harnessing the power of Social Finance)
Federal commitment to this is now at 1.2 billion with 53 hospitals already in. since 2003.
Out of 172 infrastructure projects Canada-wide 89 are in Ontario
The ” progression” of the private sector involvement advances forward from low to high risk ( for whom) positions :
Design –Build
Operation & Maintenance
Build-finance
Design-Build-Finance-Maintain *( where they are now)
Design-Build-Finance-Maintain-Operate
Concession
Privatization
Anything wrong with this ” progression potential” ?
Starting the conversation is important ; encouraging patient and family participation in the discussion is critical.%featured% My concern is the “providers/deliverers” of health care are not including enough patients or their families – the “ultimate” customer in creating solutions. %featured%The re-designing, creating is still from their perspective, not the customer. The health system needs to be “patient led”, not as they propose patient-centered. When patient-centered, the patient is still having things “done” to him or her.
Wonder why not so much reaction from the public? You know how they train an elephant in the circus? They put a big chain around one of it’s legs and secure the other end to an immoveable object. The elephant will try and try to gain its freedom. After a while it “learns” not to even try to move its foot anymore. When that learning point is reached, the elephant can be tethered by one leg on a rope to a ground peg and that is sufficient. The elephant has learned to stop trying.
I believe that is the case with some of the public. We have been subjected to such poor customer service treatment in many cases, over certainly the last 9 nine years, and we are worn down with worry, frustration. No one is listening and we are providing care to and advocacy on behalf of our loved ones. We are physically and emotionally drained. I have been caring for my Dad, a senior, the last 14 years; the medical system, hospitals, a retirement home and a long term care home have been experiences from Hades.
When the little guy or gal comes up against the might of hospitals, the MOH, a government expert at squandering the little folks’ tax dollars, the CMPA who protects at all costs doctors, no wonder the public is slow to acknowledge and react. We’ve known all about the lack of transparency and status of health care for years and years.
The glimmer of hope I had after watching the CBC Rating Hospitals’ program came from the one CEO who was on the floors, doing his staffs’ jobs, with his doors wide open to transparency. I think I also felt a refreshing breathe of air.
Call me a bruised optimist,
D Lynch
Denyse…….. what a great post. Thank you for it.
%featured%Leslee – I applaud your support of these important tools which assist transparency and accountability I and share your curiosity as to why there has been so little public reaction. %featured%These are early days and as the methodologies improve, perhaps public interest will increase. I do find it interesting that the CBC ratings – on an admittedly limited (although important) set of criteria – tended to show that those hospitals that fared worst on the scale were those that offer regional if not national tertiary and quaternary care, addressed the most challenging of medical issues, did the most complex work, were involved in important research programs and educated the health professionals of tomorrow. And those hospitals that offer a more modest range of services to often a local community tended to fare better. This begs questions that need answering, while no doubt all institutions aspire to reach an A rating.
L%featured%eslee,
Your response as CEO (sanctioned person of authority) for one of the Hospitals that did not get the “best” rating in the CBC review was a terrific lead into the %featured%discussion. You indicated that this sort of review for the lay community is relatively new and definitely has more social impact than the currently institutionalized report cards on the data from our national registry data and other “big data” repositories.
I was heartened about your unwavering in the process of **starting a conversation** amongst all our citizens, including the providers and their respective institutions.
All improvement processes begin with a conversation, understanding the many problems amongst the various components of our health system then understanding how these components are interconnected. Understanding the system and encouraging continuous problem solving by all those involved in the system (from citizens to patients, and to providers) All these players (and a few more) all have authority and always will.
Any of these exercises are excellent change management tools to assure all are empowered to get the best out of what is and should be available. These processes rather than bureaucracies are what real “Risk Management” should look like.
My son was killed due to negligence and incompetence at our local hospital on June 12/12. I am appalled at the way bad doctors are protected by the hospital and CPSO as well as being insured by the CMPA. The public has no chance to get accountability. I now have absolutely no trust in our hospitals or doctors even though I know there are good doctors out there. It is unfortunate that the bad ones are so well protected. I received my son's records 6 days after his death and have recently found out one of the crucial ones is missing. Hmmm? I have complained to the College and one of the doctors has lied more than once. However, when I sent her proof she suddenly changed her story. People are being harmed and killed at alarming rates and yet hospitals try to keep this quiet. I am sorry but our hospitals have a long way to go before they can be trusted and major changes in transparency and accountability need to be made.
Mary-lou …..
I am so sad for the loss of your son.
It will take more than transparency and accountability to fix what has gone wrong.
It will take answerability ….. which is VERY scarce :(