Ah, gaming the numbers… everyone's favorite pastime. It certainly is here in the State, even though I have my second story of the year related to gaming the numbers in the UK health care system. The first was a story about ambulances fudging and cheating their way to making the numbers for on-time response.
In this story, hospitals are gaming the system by underreporting patient safety incidents.
“…the number of mistakes to which NHS hospitals openly admit is a small fraction of the total accepted by the Government's patient safety watchdog.
It found that only 276,514 errors were recorded each year by English hospitals, even though the National Patient Safety Agency (NSPA) puts the true figure at closer to 900,000.
… almost 10 per cent of the trusts surveyed claimed an unlikely error rate of zero.”
That would be quite a headline if they really had gotten infection rates to zero. Some hospitals are making great progress on that front (with methods including Lean), but zero is darn hard to get.
People underreport for many reasons – pride, fear of being sued, not wanting to admit problems. Compare that to what I heard about during my tour of Virginia Mason Medical Center. At VMMC, one of the leaders in the use of Lean, they were happy that internally reported patient safety incidents had gone up. Had the hospital suddenly gotten much less safe? Of course not. It meant that people were finally reporting errors, which was the first step in finding root cause fixes and prevention.
It's something I discuss in my upcoming book — the need for more openness and sharing of information, both inside hospitals and across hospital boundaries. Back to work on that thing now… I'm learning you're never really “done” with a book… you just stop working on it at some point!!!
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