Skip to content Skip to navigation

Study: Government Compliance Could Mean a Worse Patient Experience

March 27, 2012
by Gabriel Perna
| Reprints

According to researchers at The Ohio State University, hospitals that adopt strategies to reduce errors and meet government requirements could face an initial tradeoff between improved clinical quality and a decline in the quality of individual patients’ experiences.

As techniques that help with federal and state mandates, such as quality process management, become mainstay in hospitals, the researchers found that unsurprisingly there were improved clinical outcomes. This included reduced medical errors and improved patient safety. However, the researchers say they were surprised to find these improvements sometimes came at the expense of the quality of the patient experience.

“Clinical quality is about doing things correctly – strict guidelines, standardization and checklists, for example – so when you consider experiential quality is about customizing health-care delivery to an individual patient’s needs, there is a tension there,” said Aravind Chandrasekaran, assistant professor of management sciences at Ohio State and lead author of the study, said in a statement.

An instance of this “tension” would be the case where clinical quality guidelines recommend a beta blocker prescription for patients who have had a heart attack, but offer no suggestions for how to effectively relay that information to a patient. While the hospital gets a good mark for prescribing the drug, a patient may not understand the instructions and possibly won’t even fill the prescription.

Despite the tension, the researchers assert that quality management systems is the most effective way for hospitals to meet state and federal mandates geared toward patient safety.

The researchers wanted to examine what happened to the patient experience as hospitals focused on new techniques to improve their clinical quality. To determine this, they analyzed four sources of data: a survey of 284 acute care hospitals in 44 states; CMS clinical quality scores publicly reported between April 2009 and March 2010; state legislative mandates for reduced hospital-acquired infections passed between 2003 and 2008 in a portion of those 44 surveyed states; and April 2009-March 2010 reports from the Hospital Consumer Assessment of Healthcare Providers and Systems survey as a measure of patient experience quality.

Additionally, directors of quality or chief nursing officers at 284 hospitals in 44 states were surveyed to determine how extensively respondents were using a data-driven, quality management system to design operations and train staff with the goal of adhering to CMS guidelines.

This research found that as organizations focused on quality process management and simultaneously increased in clinical quality as reported by hospitals, they had a decrease in the quality of the patient experience as reported by patients. State legislative mandates to improve patient safety initially reinforced this tradeoff. They did find that the earlier these laws were passed, the sooner hospital environments adjusted to operational changes so they could improve the patient experience as well. 

The researchers found that that patient-focused leadership could soften the negative association between quality process management and experiential quality, allowing hospitals to excel in both areas.

This research group is continuing its studies of the benefits of patient-centered care. Chandrasekaran noted that CMS is scheduled to begin offering financial incentives to hospitals that score well on patients’ experiential quality scores in October. The research appears online and is scheduled for future print publication in the journal Manufacturing & Service Operations Management.

Topics

News

Survey: Moving Forward on Precision Medicine Requires the Right IT Tools and Talent

May 6, 2016
Healthcare providers envision personalized medicine having a major influence on their organizations in the next two years, but it will require investing in the right technologies, like data analytics, and the right talent and skills sets.

In Blog Post, Dr. John Halamka Rips Apart Proposed MACRA Rule

May 6, 2016
In a blog post on Thursday, May 5, John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston, gave a very gloomy outlook on the recently released proposed Medicare Access and CHIP Reauthorization Act (MACRA) rule.

CMS Updates its Data for Increased Medicare Transparency

May 5, 2016
The Centers for Medicare & Medicare Services (CMS) has said that it is releasing updated data to increase transparency in the Medicare program.

Report: When It Comes to Healthcare Data Breaches, OCR Should “Prevent More than It Punishes”

May 5, 2016
To help prevent medical data breaches, healthcare organizations should embrace cyber insurance and better communicate with each other about security strategies, yet federal agencies also need to step up their preventive measures, according to a new report.

Study Indicates Web-Based Tools Can Aid in the Prevention of Major Depressive Disorder

May 5, 2016
A study conducted by researchers in Germany and the Netherlands, and published in the Journal of the American Medical Association (JAMA), showed promising results for the use of web-based, guided self-help intervention for the prevention of major depressive disorder (MDD).

Study: Teledermatology Can Improve Access to Medical Specialists

May 5, 2016
Offering virtual dermatology care to Medicaid recipients can be one potential way to increase access to medical specialists who are in short supply, according to a new RAND Corporation study.

CommonWell Adds eHealth Initiative, DICOM Grid, and Others to Its Growing Alliance

May 4, 2016
The CommonWell Health Alliance announced this week that 11 new members have joined its effort to enhance nationwide health data exchange.

Johns Hopkins Research Finds Medical Errors Third Leading Cause of Death in U.S.

May 4, 2016
A just-published study by Johns Hopkins Medicine researchers finds 400,000 deaths a year due to medical errors in hospitals.

Health IT Stakeholders Question ONC’s Authority in Proposed EHR Certification Rule

May 3, 2016
Industry stakeholders have given the Office of the National Coordinator for Health IT (ONC) feedback for a proposed rule that would give the agency more power in overseeing and reviewing electronic health records (EHR) and other health IT products.

New Senate Bill Proposes Using Project ECHO as National Model for Rural Care

May 3, 2016
Senators Orrin Hatch (R-Utah) and Brian Schatz (D-Hawaii) have introduced the Expanding Capacity for Health Outcomes (ECHO) Act with the aim of expanding New Mexico’s Project ECHO as a national model for using telehealth for rural care.

NATE, CommonWell Come Together for Interoperability Goals

May 3, 2016
The National Association for Trusted Exchange (NATE) and CommonWell Health Alliance have announced that each would become a member of the other’s organization, agreeing to establish a complementary relationship with the goal of enhancing cross-vendor interoperability.

MIPS Mobile Challenge Aims to Give Clinicians Real-Time Information and Assistance

May 3, 2016
The Centers for Medicare & Medicaid Services (CMS) has launched a competition to develop a mobile platform to help educate physicians and clinicians about the new Merit-based Incentive Payment System (MIPS) program.

CMS Finalizes Its Quality Measure Program

May 3, 2016
Officials at CMS on Tuesday posted the agency’s finalized Quality Measurement Program on its website, focusing on identifying known measurement and performance gaps and developing measures in six key quality “domains”

Survey: Most Digital Health Users Are Not Using EHRs to Manage Their Health

May 2, 2016
While 60 percent of consumers who use digital health tools say they have an electronic health record (EHR), only 22 percent of these patients are accessing EHRs to help make medical decisions, according to a survey by HealthMine.

GOP Senators Want Feds to Include Hospitals for MU Flexibility

May 2, 2016
Six GOP senators have written to federal officials to request feedback on legislation they drafted that would address the ongoing issues with implementation of the meaningful use program.

Pages