Las Vegas Sun

September 2, 2014

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Where I stand:

We must adopt a culture of sincere care

Do No Harm: Brian Greenspun

Sun Publisher and Editor Brian Greenspun talks about the findings of the newspaper's series on hospital care. To address the problems raised by the series will require a change in attitude from executive suites down, including more openness with patients and a commitment to do no harm.

When this newspaper set out in 2008 to examine the quality of health care in the Las Vegas Valley, we knew, of course, that lives are saved and medical miracles occur at our hospitals.

But there was a buzz in the community about deficient health care. We didn’t know the extent of that deficiency because there were no data to quantify it.

That fact alone was troubling.

In our daily lives, we have little difficulty tracking the quality of many of the services and products we spend money on. There are hotel and restaurant ratings, consumer complaints about automobile repair shops and published research on the reliability of appliances.

But when it comes to the quality of hospitals and the doctors, nurses and technicians who work in them, little information is available. And that doesn’t make sense. We expect the highest quality of care when it comes to the places we go for lifesaving treatment. But, in fact, we know little about what happens to patients after they are admitted.

That is why the findings of our two-year investigation are so troubling.

As they began their research, reporters Marshall Allen and Alex Richards learned of a state databank that had not been publicly disclosed.

It was a repository of hospital inpatient billing records, ordered by the state when officials worried hospitals were making exorbitant profits from powerless patients and their insurance companies. Remember those days? The state ordered hospitals to turn over billing records so they could be examined.

We sought access to that data and, with the aid of computers, analyzed 2.9 million billing records going back 10 years. The information for 2008-09 showed injuries or illnesses that afflicted patients after they were admitted. It told us how they were harmed while being healed, the stuff hospitals here didn’t want any of us to know about.

During those two years, the Sun identified 3,689 cases of patients who suffered preventable bedsores, falls that resulted in broken bones, infections or injuries during surgeries. Almost 10 percent of those cases led to death in the hospital.

So where do we go from here?

The health care community and our political leaders need to adopt a culture that says we can and must do better for our citizens. Las Vegas prides itself on its world-class resorts, dining and entertainment. Yet we tolerate hospital care that is, by some measures, mediocre.

More offensive is that some leaders in our medical community seem to accept the status quo, dismissing our shortcomings as no worse than what is found elsewhere.

What, we are supposed to settle for less than we can be? You would never hear that along the Strip.

Some hospitals across the country are committing to improving patient care. Everyone needs to read Allen’s story from Chicago, where a medical center has pledged to put patient care first. (You would have thought that would have always been the case.) The hospital’s strategy is paying off, and can easily be adopted by Las Vegas hospitals.

As a result of our reporting, local efforts are being made to improve hospital care, including the prospect of changing state law to require hospitals to be more transparent with their quality data so patients can make better informed decisions about which hospital they go to.

Early in our series, the nonprofit St. Rose Dominican Hospitals and the county-owned University Medical Center stepped toward more transparency.

Individual inclinations, however, are not enough. This is a matter for the boardrooms of the hospital companies that serve our state.

Indeed, short of legal compulsion, there are a number of ways hospitals and the people who work in them can lessen the risk to patients — by improving practices and processes that involve common sense more than they require money.

There is a logical and meaningful first step. The public has always believed that hospital boards, CEOs, and doctors and nurses have been committed to saving our lives and returning us to health.

Now that we know with certainty that preventable injuries take place, it is time for those same hospitals to add to that commitment.

Do no harm. And show us that you mean it.

Brian Greenspun is publisher and editor of the Las Vegas Sun.