Hospitals should examine what ails them, seek cure

By Brian Greenspun (contact)

Sunday, Nov. 14, 2010 | 2 a.m.

When someone is very sick, he goes to the doctor with a list of ailments and asks, “What’s wrong? Can you give me something to get better? What can I do?”

A good doctor will spend the time necessary to carefully and completely examine the patient, reach conclusions based on the information he has, and then give the patient his marching orders for recovery. It might be as simple as bed rest, or could involve taking medicine, or something as fundamental as a change in lifestyle.

Consider this a metaphor for the Sun’s ongoing examination of hospital care in Las Vegas.

In previous stories, reporters Marshall Allen and Alex Richards identified key areas where hospital care in our valley comes up short when compared with established medical standards. Those findings would be, to use our metaphor, symptoms of poor care: patients injured or killed by falls, infections and surgeries gone bad. That’s the “what” of the story.

Today, the focus turns to the “why.” Why are certain elements of hospital care deficient in Las Vegas? In a few weeks, the focus will turn to possible solutions to problems afflicting our hospitals­ — the prescription for recovery.

One intriguing question that deserves honest self-examination by the hospitals is whether they demand excellence of themselves, the way that you or I expect the most of ourselves in our own lives.

That is, are the hospitals in Las Vegas on a mission to provide the best possible care? Or do they settle on some equation of providing good — not great, but good — care while cutting corners to save money?

Las Vegas has the highest concentration of for-profit hospitals of any city its size or larger in the country. And although commercial hospitals deserve to make a profit, they shouldn’t earn it at the expense of patient care.

Quantifying patient safety in hospitals is tricky. The data analyzed by Allen and Richards — 2.9 million hospital-discharge billing records that are filed with the state — don’t allow us to rank the hospitals like we do restaurants or hotels. But they do tell us how patient outcomes measure up against medical standards. Some findings, as we have reported, are quite troubling.

For their part, Las Vegas hospital administrators point out that they adhere to standards set by regulators and accrediting agencies. Those standards, however, are minimal benchmarks to maintain licenses and accreditations. They should be considered a starting point for hospital excellence, not a standard on which to rest their laurels.

Since we launched our series in the summer, St. Rose Dominican Hospitals have become more candid when it comes to providing patients’ information about quality of care — including details about certain hospital-acquired infections and injuries — that had not been disclosed previously.

Kathy Silver, CEO of Clark County-owned University Medical Center, promised several months ago to follow St. Rose’s lead.

I applaud both of them.

There is no question that most patients are served well by our hospitals. But that does not allow us to excuse poor performance that leads to preventable harm.

When you’re not feeling well, you go to a doctor, get examined and take your medicine. It is time for our hospitals to examine themselves and identify what they need to do to set a path for excellence, because anything less should not be acceptable.

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