Las Vegas Sun

September 21, 2014

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BRIAN GREENSPUN: WHERE I STAND:

Fascination and frustration in reporting on Las Vegas hospital care

Sun creating a base year of data that can be reviewed, added to and reported for years to come

The assignment Sun reporter Marshall Allen was given two years ago was just one sentence, but would prove to be the most ambitious of his career: Find out what’s right, and wrong, about our local health care delivery system.

Marshall, who this year was named by the Association of Health Care Journalists as the best health care beat reporter in the country, is deeply sourced in Nevada’s medical community and already had a good handle on the subject.

For this assignment, Marshall set off in a number of different directions. One goal was to somehow quantify the quality of health care delivered in our hospitals based on statistics and facts, not perception and opinion. Marshall huddled with the Sun’s computer-assisted reporting expert, Alex Richards, who is trained at numbers crunching and analysis.

What they found will fill many newspaper pages. The first of their findings is published today as we launch the series, “Do No Harm: Hospital Care in Las Vegas.” More stories will follow in coming months, because they found a lot.

The information they report today is fascinating, yet frustrating.

Fascinating, because Marshall and Alex latched on to data that hospitals are required to provide the state for government analysis — analysis that had not yet been conducted by the state. We didn’t want to wait, so we requested the data and analyzed them ourselves.

Consumers in Las Vegas will, by looking at our charts in the paper and online, now be able to study, hospital by hospital, where certain kinds of harm to patients have occurred. Informed patients can then decide which hospital to go to.

The story is fascinating, too, because even with such focus these days on national health care reform, the hospital industry has resisted transparency. Hospitals clearly know the outcomes of the patients they treat, but few seem to want those figures publicized. We are forcing their hand. If they won’t disclose to us the ways in which they harm patients, we will. That’s what a responsible newspaper does.

And the results were fascinating because, as far as we can tell, no one else — not government, not the hospital industry, not any other media — has done the kind of hospital-by-hospital analysis that Marshall and Alex are writing about today, examining how patients run the risk of being harmed by the very hospitals they turn to for healing. That patients fall ill, are injured or are seriously infected while in a hospital flies in the face of a fundamental principle for health care providers: First, do no harm.

Here is where the frustration comes in: Everybody will wonder, and rightfully, how we compare with other parts of the country when it comes to the rate of patients acquiring hospital-inflicted injuries and illnesses.

We can’t tell you that. We can’t, because nobody else has publicly conducted the kind of analysis we have. It seems to be unprecedented, in part because states, operating under different levels of transparency, have different ways of gathering and examining hospital quality and safety. We can only wish a national mechanism were in place so outcomes could be consistently measured and openly reported to the public.

But that isn’t to say that the findings published in today’s stories lack meaning or value.

The people harmed in Las Vegas hospitals in 2008 and 2009 may be enjoying their first measure of accountability for what went wrong. They have not been forgotten.

Additionally, we are creating a base year of data. In coming years, we can review new data and see how they compare with the rate of patients being harmed in hospitals in 2008 and 2009.

We’re proud of our role in helping to improve medical quality.

We hope that, ultimately, we won’t have to repeat this task in future years — not because we don’t want to, but because we hope hospitals will recognize the value of full transparency and the intrinsic rewards of addressing their own shortcomings, so that they can better serve the community.

That’s what we deserve: for hospitals to do no harm.

Brian Greenspun is editor of the Sun.