Quality control

In any given conversation about U.S. healthcare, it's almost a sure thing that the word “cost” will quickly come into play, especially given today's political and economic realities. But you'll just as likely hear talk about “quality”—probably complaints about why there's not nearly enough of it in light of our nation's bloated healthcare spending.

So are cost and quality correlated? Of course they are, with study after study pointing to subpar care—and all its attendant extra services and expense—as helping to drive the cost curve ever higher. Think of hospital-acquired infections and needless readmissions as just two examples.

For further compelling evidence of an interconnection, I urge you to read a report by Modern Healthcare's Joe Carlson in the special supplement accompanying this week's issue (also available at modernhealthcare.com/100tophospitals for online readers). The story is based on exclusive research conducted for Modern Healthcare by Thomson Reuters that provides strong evidence of how lower spending on drugs and other supplies at high-performing hospitals can lead to improved quality while at the same time trimming expense. In an era of exceptionally tight resources, it's exciting to see proof that it's possible to accomplish more—clinically and financially—by consuming less.

Certainly the most cost-effective form of healthcare is when no care is delivered at all because it just isn't necessary. It's when the need for healthcare is prevented. And when healthcare isn't provided, it's much harder to make an egregious medical error or commit malpractice.

We're all aware of our personal responsibilities on the prevention front to help keep us out of the hospital. Collectively as a nation we're too sedentary and carry too many pounds, placing us at higher risk for heart disease, diabetes and other illnesses. Large numbers of us still smoke, aren't getting enough sleep and face an overload of stress. That's what public health experts and probably our own doctors have been telling us for a long time now. It's time to listen and take action.

But when it comes to prevention, healthcare providers also need to listen and make some changes of their own. Is everyone remembering to wash their hands? Yet another study, this one published in the September issue of the American Journal of Infection Control, indicates that poor hand hygiene continues to be a problem among healthcare professionals. The same study warned that doctors' white coats and nurses' scrubs also often harbor dangerous bacteria, raising the infection risk. So apparently, caregivers not only aren't washing their hands often enough, they also could use some help with their dirty laundry.

Meanwhile, with another flu season approaching, the Centers for Disease Control and Prevention continues to recommend that nearly everyone receive an annual flu shot to help lower the risk of infection. For some reason, however, surprisingly large numbers of healthcare providers choose to ignore this advice and forgo vaccination. According to a CDC report from mid-August citing data from the 2010-11 flu season, only 63.5% of healthcare workers overall got a flu shot. The percentage was highest among those working at hospitals, 71.1%, while lower at long-term-care facilities and among home health workers, 64.4% and 53.6%, respectively.

With influenza perennially among the 10 leading causes of death, for healthcare providers to put up those numbers is quite shameful, especially for caregivers working with frail seniors, the most vulnerable. The time might be at hand for compulsory vaccination for all.

For very little cost, healthcare providers have it within their power to continue making quality strides. To a great extent, it's literally in their hands. And their arms.