WHENEVER I VISIT the corporate offices of THE DARK REPORT in Austin, Texas, I am invariably treated to a Texas barbeque dinner and one of the delicacies on the platter is sausage that has been smoked and slathered in sauce. Like many of you, I enjoy sausage, but I don’t ever want to watch how sausage is made.
We all know how that concept applies in healthcare. Most patients shouldn’t see how their healthcare is “made.” And it has been the practice of hospitals and physicians not to make public their flaws and warts, as uncovered by accrediting agencies such as The Joint Commission (formerly JCAHO–Joint Commission on Accreditation of Healthcare Organizations.)
But that is changing. I am going to tell you about a refreshing and candid public analysis of a recent Joint Commission inspection of the Massachusetts General Hospital (MGH) in Boston! And it comes, warts and all, from MGH President Peter L. Slavin, M.D. In a letter to the public (at www.massgeneral.org/message_april07.html), Slavin says a commission survey team spent five days at MGH in December and found 10 areas of concern (called RFIs—Requirements For Improvement). “We were not happy with 10; in fact, we would not have been satisfied with seven or five or two RFIs,” Slavin wrote. “Our goal is zero. This week, we sent to the Joint Commission our action plan for addressing each of these RFIs, and we will closely monitor these areas to ensure we are not only improving and achieving compliance, but also excelling.”
In a list accompanying the letter, the hospital details the areas needing improvement and the corresponding steps MGH is taking. By making the commission’s findings and its response public, MGH is raising the bar for hospitals nationwide. MGH recognizes that transparency in hospital quality, infection control, and pricing are growing national trends. But when a major healthcare institution—and a proud one at that—is willing to show its flawss to the public and admit areas that need improvement, then we have indeed entered a new era in public transparency.
I applaud Slavin for stepping forward and openly reporting on MGH’s RFIs. This development represents what I hope will be a trend: more accountability among hospitals nationwide as they publish their accreditation results and tell the public what they’re doing to make improvements.