Quality Initiatives and the Healthcare Law Verdict

June 20, 2012
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Will patient care reforms survive the healthcare law ruling?

With the expected decision on healthcare reform by the Supreme Court, what will happen to patient safety and quality reforms taking place under the Affordable Care Act? In an article in Scientific American, several healthcare experts said that patients will suffer if the law is struck down.

Yet a recent story in the New York Times also points out that initiatives that hospitals have already put in place will have a lasting impact, and the economic pressure to provide better care to more people is irreversible. To illustrate its point, the article uses the example of 711-bed Maimonides Medical Center in Brooklyn, N.Y., which has achieved above average clinical outcomes and low mortality rates for pneumonia, heart failure and heart attack (although its patient satisfaction scores are also low), the article notes.

As noted in the Times article, the hospital has taken a home-grown approach to improvements. One example: it has asked labor management teams in every nursing unit to come up with their own improvement projects; one initiative has nurses making hourly rounds to offer patients extra help.

Another example: in an initiative undertaken a few years ago, Maimonides collaborated with a state psychiatric hospital to put mental health teams in storefront offices to care for low-income patients with mental illnesses, which reduced emergency department use by 30 percent and cut hospitizations by half. The hospital is now expanding the program in collaboration with community agencies and nearby Lutheran Medical Center.

The point is that these initiatives, which originated with the hospital, have made significant improvements in patient care, and, according to at least one Maimonides administrator, the improvements are here to stay. "If the Supreme overturns this law—and I pray it won’t—the world will go on changing,” Pamela S. Brier, Maimonides' chief executive, told the Times.

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