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Sunday, June 27, 2010 | 2:05 a.m.
It has been widely reported that the health care industry accounts for one-sixth of the nation’s economy, yet how much do people know about the quality of care they’re getting? If you buy a book, a cell phone or a car, you can find detailed reviews quite easily on the Internet.
But with health care, reliable information is much more difficult to come by. It shouldn’t be that way, but hospitals and the health care industry have fought attempts to make them more transparent.
For the past two years, Las Vegas Sun reporters Marshall Allen and Alex Richards have investigated the quality of care at Las Vegas hospitals. They analyzed 2.9 million inpatient records that hospitals send to the state to create a unique portrait of care that appears in today’s edition. Their reporting raises troubling concerns about “hospital-acquired conditions,” preventable injuries and life-threatening infections that patients can suffer in a hospital.
For example, they found that in 2008 and 2009 there were 969 cases of preventable injuries and infections in Las Vegas. Included were 21 cases in which a foreign object was left in a patient after surgery, 79 cases in which patients developed sores that hollow out the flesh and 248 cases of patient falls or other injury after surgery.
Some of the cases of harm are hospital horror stories about medical errors and neglect. In one instance, a surgeon removed what was thought to be a cancerous mass — it turned out to be the patient’s cancer-free kidney. In another instance, a patient who went in for heart surgery ended up with debilitating bedsores that go to the bone and are still healing two years later.
The Sun’s reporting is eye opening and is based on painstaking research. Hospitals have held the information close to the vest, and did not want to discuss it, complaining it would violate the federal law intended to protect patient privacy. But the information doesn’t violate the law — no names, birth dates or other personal information are in the data.
In 2007, lawmakers ordered the state to make the information available to the public. Hospital officials have tried to stop its release. One regulator said the hospitals suggested that making the information public could lead to a lawsuit against the state or could result in hospitals reporting fewer problems.
That lack of transparency is troubling, but it is common for the hospitals. Assembly Speaker Barbara Buckley, D-Las Vegas, has been an advocate for making information like this more accessible and said the hospitals “have been resistant to change every step of the way.”
Legislation requiring more hospital transparency passed during the 2002 special session over the objection of the hospitals. Lawmakers hoped it would push hospitals to improve care and drive down costly medical errors. The legislation created a state registry of “sentinel events” at hospitals, unexpected incidents in which a patient is seriously harmed or faces the risk of harm. Hospitals are supposed to report those events to the state.
In 2008 and 2009, hospitals reported 402 sentinel events statewide, but the Sun found 1,363 statewide incidents that fit the definition. The hospitals argue that many incidents the Sun identified don’t actually rise to the level of a “sentinel” event, instead calling them “adverse.” But that’s just a shameful game of semantics. Regardless of what they call these cases, hundreds of people still suffered some sort of injury or life-threatening infection at a hospital.
The release of such records is not only embarrassing for hospitals, it could be costly. Medicare has stopped paying for hospital-acquired conditions. Most insurance companies, however, still pay for them, but they may reconsider with a full understanding of the data. If there is pressure on hospitals to curb avoidable injuries and infections, that should reduce health care costs, which is good for patients and taxpayers.
Although curbing costs is important, patient safety is paramount and these data provide patients with a way to compare hospitals and make informed decisions.
“Do you have the right to know about the quality of care you’re receiving?” Buckley said. “I think you do. When you buy a car you can go to Consumer Reports. Isn’t someone’s life worth more than his car? I would think so.”
So do we. It is terrible to read stories of patients who enter a hospital for healing only to end up in worse shape, suffering from something preventable. This has to change.
Patients should have information about hospital quality before checking themselves in. The hospitals should stop trying to downplay the reality of the situation, and instead, the hospitals should study it and find ways to improve their care. And state regulators should make sure the hospitals are working to limit these preventable injuries and illnesses.
Hospitals aren’t supposed to make people sick.
This will be interesting to see how everything unfolds. The Sun needs to look at physicians too, they are an integral part of the hospital system. How effective are they? Do they perform unnecessary procedures to pad their pocketbooks? How many times are they successful at treating an injury or disease?
When everything unfolds, I hope to see what is positive about hospitals and physicians and be able to make an educated choice about my health care.
When my mother went in to the hospital, after seemingly (and really) 2 years of trying to figure out where her pain was coming from she was admitted to the hospital on East Flamingo.
There we felt like we were in three different hospitals.
The first was when mom was first admitted was generally upbeat and overall services were done with a smile. It turned out moms condition was very serious and the doctors were (now being changed weekly because of their rotations) were of differing opinions as to the outcomes and possible treatments for what turned out to be a very final stage cancer.
They then told us they were transferring her to a better part of the hospital because she would get better care there. They lied. It was a dumping ground for terminal or low insurance paying (mom had senior advantage and the professionalism and level of care took a huge nosedive. It was awful, the staff were like zombies now, unwilling to answer questions, unfriendly, and totally unprofessional.
Mom flatlined here and she never spoke another word, though she smiled and listened to us with that awful tube down her throat while they moved her to ICU.
In ICU it began to really dawn on us as a family that it was our turn to lode a loved one, we had been immune to it up till that point. The staff here was A+ and when the day came we decided to allow nature to take it's course and turn off the machine, our family gathered at mom's bedside to "pull the plug" we told her we loved her and were ready and were sorry. Before the nurse could arrive to turn the machines off the dials over the next 60-70 seconds turned to zero and move, having had her lungs eliminated as breathing devices by this cancers changed addresses and went to heaven.
The hospital did nothing to move the body or take the stuff off of her till we about screamed for it. They left her looking awful. It would have been nice to have her laid back and covered up, we did what we could. There didn't seem to be a good guidebook for what to do. We were all new at this.
I wound up in the ER at the same hospital the following week I was diagnosed as having a heart attack (I didn't) and was left in the ER for 12 hours while they looked for a bed (so they said) and they found nothing wrong with me. My bill for the stay was just over $25,000. I had one meal I think, my most expensive dining experience ever.
I really have major qualms about the quality of the doctors in this town. And it is because after they see what needs to be done, they scurry down the hall like little slaves to the insurance industry and get permission to do who knows what. It is in almost all cases the cheapest they can get away with, not the best for me.
Udde, the U.S. does have some of the best health care in the world. These accidents and acts of negligence occur in Europe too. Here in America some of these are preventable but are actually incentive's by U.S. government policies that pay doctors per event. This means doctors are accidentally rewarded for every accident they make.
"The Institute of Medicine, a non-partisan research organization chartered by Congress, estimates that 50,000 to 100,000 hospital patients die in the United States each year as a result of preventable errors. That's almost three to six times the 18,000 Americans the IOM estimates die each year because they lack health insurance"
http://www.cato.org/pub_display.php?pub_...
Is Las Vegas becoming another "hole in the wall" city like Phoenix, AZ? If we are to ever improve this state, we need to make darned sure that doctors are doctors, lawyers are lawyers, accountants are accountants, teachers are teachers, etc.... These people are not entitled to legalized criminal misconduct just because they wear the professional label.
Nevada needs to diversify it's economy by starting up business's that can pay living wages. Business's are not going to come to Nevada just because there is no personal income or corporate tax. Those repeating that do not seem to understand that people who work for the business community have families that want to live where is is quality education, quality health care, and low crime.
Wake up Nevada and change for the better!
The state must interview physicians and other personnel involved in quality control. What have they been doing? Personnel entrusted with quality control ,are people who work in the system (hospitals), which generates their income. Obviously, they have a bias towards not reporting events which hurt hospitals reputation.
There are prominent people in town who provide personnel to hospitals for quality control. These people generate large income from basically playing the game which hospital CEO's want them to play i.e ., not report incidences or under report. The hospitals reputation is maintained, which generates income. Quality control personnel get paid. So everybody is happy.
Where you find a quality control person who is doing his or her job, diligently, rest assured this person will not be doing quality control for long. Do it hospitals way, i.e., not report or under report, or be on your way, highway. People need work, have income to provide for their families, so they compromise.
There is also a culture in hospitals, kill the messenger, where conscientious physicians / nurses, who stand up to the hospital and complain about poor quality care are reprimanded. Most physicians/nurses know about such behavior by hospital authority, and so keep their mouth shut and do what they can on a personal level for their patients. Unfortunately, there is only so much they can do.
On the whole what Mr. Marshall Allen writes is factual, in this article as well as the one's in the past.
I am sure most articles written by Mr. Marshall, have been anonymously helped and supported by physicians/nurses, yet Mr. Allen has never thanked them in his articles. I would like to see Mr. Allen, thank people who provide him quality information. He could say at the end of his article, I thank all persons or physicians/nurses etc who have helped provide information for this article.
Mr. Allen may have thanked them personally, but to thank them in public, even though keeping them anonymous, has another meaning.
There are physicians/nurses and other people, who want the culture of neglect in our health care system be stopped, this is why these health care personnel speak to journalists.
Acknowledging them also informs the public that all in our health care system is not bad, there are people who care enough, to enlighten public through journalist like Mr. Allen, at times at great risk to themselves, so that pressure be brought upon hospitals to improve quality of care.
Comment removed by moderator. Off-topic.
Udde, 8 of the last 10 medical tech breakthroughs came from the United States.
Comment removed by moderator. Off-topic.
Sun, you know your enforcement of the off-topic code is quite arbitrary. Yesterday you allowed conversations on the subject of the G20 protests (a topic I don't think you've covered yet, but maybe I've missed it). What happened?
Fos, recent medical studies have shown that underweight people have a higher chance of heart disease than overweight people. Turns out how we classify weight (BMI) is a poor predictor of health.
To lasvegan2008 (and everyone else): You are absolutely right that our sources are the doctors, nurses, patients and other health care stakeholders and insiders -- most who are never identified (at their request). I could not do my job without them and my hat is off to them. A journalist could not do ANY investigative story without the help of many sources. I admire their courage and their willingness to speak to me in private about the things they are seeing. I appreciate them and do not take them for granted.
It would be too cumbersome to thank "all the sources" at the end of every story, so we won't be doing that. Just know that we know it's impossible without the sacrifice of many people.
Also, I would appreciate if more folks who know what's really going on would be willing to get in touch with me. You can call me at 259-2330. I only insist that you tell the truth!
Just want to say thanks to Jeff From Vegas for sharing his painful ordeal. Meaningful statistics are necessary to make good decisions, but too many people forget that real lives are at stake here. Good on the Sun, too, for highlighting issues that will eventually affect every single one of us.
Okra,
Because mom had been left to scream with no one willing to answer her the first night (after dad went home to sleep) with her thinking she had died she asked me to not leave her there with the hospital staff. From that second day on a member of our family was there 24 hours a day until she went into the ICU, when they barred us from staying in there.
I can only imagine her fear of waking up after being "passed out" from over 24 hours of testing that started at a doctors office and had concluded in the ER that they let her scream without anyone answering her. She never made it home again. It took almost 7 weeks there. Mom died in April of 2009.
Now on Friday my dad has been diagnosed with prostate cancer. Bone scan to follow, please pray for him if you have the time.
Thanks for your comments.
Bush, Chaney, and McCain go to Walter Reed Army and Bethesda Naval Hospital and haven't had any problems. Government bad - private sector good?
Comment removed by moderator. Flaming.
Really sorry, Jeff, and I have no idea whether it matters or not, but best wishes- and prayers -to you and your family.
Patrick,
You wrote, "Sun, you know your enforcement of the off-topic code is quite arbitrary."
Yup.
Depends on which editor is back-reading the comments. I may be more restrictive than my colleagues. I really want the comments to be focused on the story and not to ramble. I want good, constructive discussion and not attacks.
Good thing my comment was merely posting news stories on a subject not covered by the newspaper then... :)
I've removed these comments. I had said an article that was linked to seemed on-topic but it triggered a succession of comments that were increasingly off-topic and led to some flaming so, like a baseball umpire changing his mind, I've stepped in.
tom
Comment removed by staff.
(Sorry Tom, I beat you to it!)
and then apparently he removed almost everyone's comments hahaha. The rest of the topic was on the nurse strike somewhere else in the world.
Comment removed by moderator. Personal attack.
Journey
I feel most physicians are angry with the bad press some surgeons cause there wonderful profession.
Unfortunately AB10 "Whistleblower" law doesn't work when certain reporters trash them for stepping forward. Why would any medical professional [Dr. or RN] dare to bring observations to Administration or SBME when it is them that get roasted for squelling?
Interesting events with Western Regional not apparently having any spine surgeons to fullfill obligations at Sunrise. The fractured partnership has left Smith, Garber and Kaplan with the low rent district while the others hit the trail and moved to Henderson. Seems no one wants to cover Sunrise..
With Cyprus and Thailand paying cash for Smith's services how will Valery balanced all those off shore deposits and expenses, especially with all his real estate holdings in town under water.
Something should be done when the State Board still has not posted Kabin's problems and convictions nor really processed all the info on Smith.
The public demands surgeons who are around and visit their patients immediately after operations, rather than flying off for cash patients abroad formedical supply companies..
Should they have privilages when they don't follow up after operations or return calls promptly?