According to Trisha Torrey, a patient empowerment expert for About Healthcare, the word transparency refers to "the reporting of medical errors, pricing, never events or other pieces of information that medical facilities, manufacturers and providers have resisted sharing to date." The National Patient Safety Foundation defines transparency as "the free flow of information that is open to the scrutiny of others."
In order for patients and health insurance companies to make informed decisions, they need transparency into quality and safety information. Common sense and consumerism support the idea that patients might choose a doctor based on a successful track record or might refuse to be treated in a hospital with a record of hospital-acquired infections.
In an article about transparency, Vivian Lee, M.D., Ph.D. M.B.A., uses the term "Information Asymmetry" to describe cases in which patients cannot be considered informed consumers because they do not know as much about their health and biology as their healthcare providers. Therefore, they cannot judge the quality of the care they receive. How then do we balance the patient's need to know with their ability to know and understand safety and quality performance?
One suggestion is to assess the organization's medical staff structure to see how it prioritizes patient safety and how it makes information transparent. The Joint Commission Hospital Accreditation Program standards clearly define the structure and responsibilities of the organized medical staff. Some believe efforts have been more about protecting quality information than making it transparent. The fear of litigation is most often cited as the major reason to protect this information.
To build a more safety-driven medical staff, consider these transparency enhancement concepts:
• Have a process for communicating with the medical staff about publicly released information. Be aware of exactly what information will be made available to the public and the formats in which it will be reported so the medical staff has advance notice.
• Make it easy for physicians to share recent patient safety lessons amongst themselves or through continuing education sessions.
• Appoint, in advance of any need, medical staff members to discuss results with patients and their families, as well as in public forums. These individuals must have the ability to engage with patients and families, and answer the tough questions, when necessary.
• Ensure that credentialing and reappointment processes for medical staff members include safety performance data.
• Proactively adopt a leadership engagement strategy for transparency. Show that it is a positive step toward healthcare quality and safety, and a competitive tool for the organization.
• Emphasize that cooperation around eliminating all safety incidents among all hospital staff is essential in order to honor the trust of each patient and sustain a viable organization. Launch recognition programs to celebrate safe caring efforts of individual physicians.
Embracing transparency will help encourage all physicians and leaders to continually learn and fulfill the promise of a safe environment for every patient.
Virginia Davis, R.N., Ed.D., C.P.H.Q. is the principal clinical consultant for DuPont Sustainable Solutions, the safety culture consulting division of DuPont. She can be reached at virginia.davis@mail3.dupont.com
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