Eliminating patient harm and waste in the delivery of health care not only saves lives, but boosts the financial performance of health care institutions, according to Richard Shannon, M.D., the Frank Wister Thomas Professor and chair of the Department of Medicine at the University of Pennsylvania.
Dr. Shannon delivered his address “Building a Better Case for Quality” on Tuesday, Feb. 5, in the John H. Ammon Medical Education Center at Christiana Care.
Dr. Shannon is a nationally recognized expert in patient safety. His pioneering work is chronicled in the chapter “First, Do No Harm,” in “The Best Practice: How the New Quality Movement is Transforming Medicine.” He has been featured on CNN and in the Wall Street Journal and the New York Times.
By eliminating errors and waste, health care providers fulfill their moral imperative to do no harm, said Dr. Shannon, who is a board member of the American Board of Internal Medicine. “That’s the starting point. It can take 1,000 days through process and systems improvement to get to point where you have eliminated, not merely reduced, hospital-acquired infections.”
Improving the quality of care can dramatically impact the bottom line. “That can be vitally important for hospitals during times of limited resources,” he said.
It is unfortunate, said Dr. Shannon, that health care providers never stop to consider the lost financial opportunity associated with poor performance. “Embedded in inefficiency and harm are significant opportunities. Health care providers have almost a complete lack of understanding of the costs to deliver care. This inability to understand and measure cost is a barrier to improvement.”
While at Christiana Care, Dr. Shannon met with clinical scholars at the Christiana Care Value Institute, with clinical chairs and with Department of Medicine unit-based clinical leaders.
“Christiana Care gets it,” he said. “The leadership at Christiana Care understands what it takes to be great. You can be more successful in eliminating errors because you are more rooted in the community than large urban hospital systems. Having patients as your neighbors provides an added incentive.”
He noted that the Christiana Care Value Institute is creating a systems infrastructure to gather and analyze data that can motivate and drive improvement. “The Value Institute will create a disciplined problem-solving approach — a common language whereby everyone in the organization sees and solves problems.”
This is not always the case, according to Dr. Shannon. Health care today is awash in meaningless measures, and providers are infatuated with reportable — not actionable — data. Moreover, they don’t share a common language. Finally, he noted that “it is critical that we give people the time and space to learn how to be better.”
Dr. Shannon provided examples of how eliminating hospital-acquired infections saves money. More than 70 percent of one patient’s hospital bill of $246,000 was directly attributable to a needless hospital-acquired infection. The hospital lost more than $41,000 as a result. “When care is compromised by infection, you lose money.”
The University of Pennsylvania’s 1,000-day journey to eliminate central-line infections brought a financial improvement of more than $10 million. By reducing the average length of patient stay by 10.7 days, the hospital was able to care for an additional 623 patients, resulting in more than $3.6 million in revenue.
More importantly, Dr. Shannon said, the elimination of infections saved 65 lives.