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Health Care Measures Everything Except What Really Matters To Seniors

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As board chair of a community hospital, I am often confronted with the dozens of quality and safety measures that state and federal regulators use to score and pay us, and private organizations use to rate us. And as someone who works to improve the quality of care for older adults, I am struck by how much all these measures miss when it comes to what really matters for seniors.

Here’s an example: Imagine an 85-year-old widow with mild dementia who lives alone at home. She comes to the emergency department of her local hospital with severe hip pain. She is treated quickly and efficiently in the ED. The orthopedic surgeon finds that she has severe arthritis and determines the best treatment is hip replacement surgery.

No complications

The surgery goes well. There are no complications. She gets no infections of any kind. She never falls during her hospitalization. All her doctors wash their hands coming in and out of her room. She gets a flu shot and a vaccine to lower her risk of pneumonia. Her pain medications are administered appropriately (not too much and not too little). Her nurses quickly respond to her call bell and her food is hot. With her permission, her daughter, who lives out-of-state, is kept well informed of her condition.

After a few days, the patient is discharged to a skilled nursing facility for rehab, and is not readmitted to the hospital for any reason directly related to her surgery. After a time in rehab she goes home.  Her surgery and hospitalization went smoothly. Everybody did their job and the hospital will get a great score based on all those required metrics.

Better outcomes

But did all that highly-rated medical treatment improve her life? Is she, in the most important sense, better off than before her surgery and hospitalization? Those questions are not so easily answered, and they largely are never addressed by all the star ratings and other quality and safety measures that hospitals must manage.

For example, could the patient have had a better outcome if, instead of hip surgery, her pain was better managed and she was encouraged to lose weight and make modest changes to her lifestyle?

Article source: https://www.forbes.com/sites/howardgleckman/2017/12/06/health-care-measures-everything-except-what-really-matters-to-seniors/

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