Last week I sat in a long and rather boring department meeting. The hospital executives were going over new software that will supposedly help improve the quality of care that we provide to our patients.
This particular program will enable healthcare providers to log in and see how we are performing when compared to other employees based on statistics. This was only one of many “quality” improvement measures that were discussed at this particular meeting.
As my mind wandered, I started thinking about the word quality and how it applies to healthcare. It is certainly a widely used term in our field. Everyone wants to talk about quality indicators and benchmarks when discussing healthcare improvement.
But I found myself asking: are we really just improving statistics, while the actual care of our patients gets lost in the clutter of paperwork and graphs?
The first example of this paradox that came to mind was electronic health records and meaningful use incentives. EHRs are supposed to improve outcomes, improve communication and streamline medical record keeping.
But in the almost 18 months that I’ve been using the EHR in my office, I can honestly say that I often feel distracted from what my patients are saying. I’m so worried about documenting everything properly. Achieving meaningful use for EHRs has become more important than having meaningful patient interactions.
I understand why the push for measurable quality indicators exists. Patient safety issues, rates of infection and medical errors must all be carefully monitored, and flaws in the system need to be addressed and corrected. However, in the current state of medical practice, the push for “quality” seems to extend to a realm beyond achieving this goal.
Every day it seems like there is a new document to be completed, another meeting to attend and another step in the process of caring for patients. The bottom line is to provide the best care to patients, but at the same time, these actions take more time and attention away from the patient.
Often I find myself feeling that we have lost sight of establishing the hands-on, provider-patient relationship that creates true quality care, and which leaves our patients feeling satisfied.
It’s important to step back and look at the big picture. Is our actual healthcare truly better than it was 50 years ago? Certainly we have access to more research and technology, but is all of this performance improvement truly benefiting the patient? I’m not so sure. Please tell us your thoughts in the comments section below.
Robyn Carlisle, MSN, CNM, WHNP, works as a full-scope midwife at University Doctors and Kennedy University Hospital in Sewell, N.J.