At ClearHealth/CLH we defined thousands of core business processes in a typical over 100 bed acute care institution. These are complicated animals. A hospital of any size is pretty much a city unto itself. There isn't one thing, there are a lot, a lot of things from how items and equipment are procured which is very complex to simple things like making sure that people wash their hands when they should. How laundry and trash are handled. HVAC and plumbing are insanely complex in a hospital setting. It is absolutely absurd how viscious the fights get between staff and management over parking assignments. It requires virtually a threat of termination to make a lot of doctors follow even a 3 to 8 step evidentially developed checklist for certain situations.
ACHC, joint commission, CLSI for laboratory, are groups that outline some very basic frameworks of how facilities should be operated. Less than half of facilities can meet even these extremely low bar standards for operations. It is difficult for me to see how many patients have been harmed by ransomware impacting hospital opertions, this is entirely preventable and no one on the hospital side has been meaningfully held accountable so very little will change.
A counter example is the pricing transparency regulations. Failure to meet those is resulting in multi-million dollar a year fines which is resulting in change. It is happening slower than people like or had really conceived of but it is causing some real meaningful change.
99,000 americans a year die from hospital acquired infections that are entirely preventable using procedures and operations (not surgeries) that are known and evidentially proven. It's just really hard to get all of the parts of the orchestra to play the same tune so those people die needlessly.
Is there some way a non expert can assess a particular hospital by these measures? What I'm getting is that most hospitals introduce more risk than they should, but if I find myself needing one I have zero idea how to not make picking one feel like flipping a coin.
"99,000 americans a year die from hospital acquired infections that are entirely preventable using procedures and operations (not surgeries) that are known and evidentially proven. It's just really hard to get all of the parts of the orchestra to play the same tune so those people die needlessly."
??? I dont get this. The problem are Antibiotic resistant bacteria. You go to a Hospital (ER) and have a open wound.. chances are you die of an infection. How is this preventable??? This is a big problem atm and there is no good solution. you cant test people if they come in bleeding like hell for Resistant bacteria.
I mean you can but ...
I would like to hear the solution to that problem. Thank you.
I once spoke with a nurse who said they have the walls scrubbed on a regular basis. I can't recall if it was daily or weekly, I think weekly.
They're not paying the nurses to do that, the people who are doing it probably consider it shitty work and I wouldn't be surprised if things get missed due to the sheer crappiness of the work.
I think there's probably a reality there that can't reasonable worked around. Sure, in theory a perfect scrub will solve the problem but how do you regulate that into effectiveness?
The best you can do is to design tools to make it less shitty but you'll never make it non-shitty.
In germany we have this allready but it doesnt work. It reduce the problem. But the real problem is ER. In a life death situation it doesnt work. ER are very hard to keep clean. But yes you are absolutly right
EDIT:// I am no doctor but did work in Hospitals. Doctor friends working in ER are telling me about those dangers. And also bigger Hospitals have less control about it.
220nm light is under investigation since it's germicidal but so far appears far less harmful to humans than other UV ranges. If those findings are validated we might see some permanent narrow-band, low-power UV lights in hospitals.
For one, the payment setup in the US is a massive burden to proper care. For every screen and procedure that gets logged into an EMR system, there is some resulting billing setup that is complex, overburdensome and user hostile. The billing setup is so bad in the US that there are whole armies of companies who's job is literally to just collect revenue for unpaid bills (RCM - Revenue Cycle Management), many of which are the result of a confusing billing and invoicing system.
Source - I've done diligence on at least 75+ EMRs/EHRs.
