NQF readmissions study not about quality improvement, and other letters

Regarding “NQF to study socio-demographic factors in 30-day readmissions,” I find it ironic and more than a little telling that the motivation behind this study is not to actually improve quality of care. It's to prove to the CMS that safety net hospitals are “disadvantaged” if held to the same readmissions standards used for everyone else, and deserve an adjustment that ensures that they don't lose revenue in the larger effort to improve the quality of care. Interestingly, that's pretty much the same argument made by many inter-city school districts, and largely for the same reason.

It's also reinforcement for the power of money to shape behavior. Spend federal funds to pay for services without any real quality contingency, and you get provision of services that are not tailored to the marketplace. Mediocre results follow.

It's all too predictable in the context of a mindset that thinks more government regulation and more money is the answer to every problem. What we need is to hold all providers accountable to the same standards, and find ways to empower patients to go to providers who meet and exceed those standards.

Michael Abrams

Regarding the blog post “Medication reconciliation improvements needed: report,” technology is only as good as the folks using it. People must not allow technology to replace thinking and thoughtful interaction. Recently, while getting ready for an interventional radiology procedure at a major Philadelphia hospital, I was handed a list of medications and asked which ones I took that morning. The list did not belong to me. It actually had another patient's name on it. Not only was the list for the wrong patient, but the visibility of another's name along with protected health information was a violation of HIPAA.

Technology may have its place, but it also has made healthcare professionals increasingly sloppy thinkers.

Mary Powell