Welcome to No Harm Done Episode 4 hosted by Cathy Balding and Cathy Jones, from Melbourne, Australia. In this episode we zoom in on data as our Quality Quandary. Adverse events. Complications. Audit. Public reporting. What does it all mean? Plus we discuss the advantage of getting rid of rules in Dr Dr and The Point considers some of the issues associated with being a ‘good’ patient – or not. And much more! What would you like us to talk about next? Send us a message below!
Intro & Quality Quandary: The QQ is a big issue we unpack, explore and maybe even argue about. Our quandary this episode tackles ‘How do you measure that?’
15.30 – Quality Tools for measurement – audit
Mohammed Pyramid: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1464080/
24:10 – Too Long Didn’t Read (TLDR): We read this loooong publication, so you don’t have to. This one you should, though! ‘All Complications Should Count: Using our data to make care safer’ by Christine Jorm and Stephen Duckett from the Grattan Insititute. One in every nine patients who go into hospital in Australia suffers a complication, and if they stay overnight the figure increases to one in four. Has collecting the same set of risk data over and over made a big enough difference? What about all the other things we should measure?
Ref: Report: https://grattan.edu.au/report/all-complications-should-count-using-our-data-to-make-hospitals-safer/
Complications calculator: https://grattan.shinyapps.io/all-complications-should-count/
37:10 – Hot off the Press: This article published in May 2018 caught Jones’ eye. Mortality rates decreased after public reporting was introduced in England.
Ref: Effect of public reporting of surgeons’ outcomes on patient selection, “gaming,” and mortality in colorectal cancer surgery in England. https://www.bmj.com/content/361/bmj.k1581
43:10 – Did Read, Do Read (DrDr): This is an article we’ve read recently (or one from the vault) that we highly recommend you look up and read yourself. This one discusses breaking the rules in your health service to improve care. Sounds like fun!
Ref: Breaking the rules for better care. (Berwick et al, 2017)
51:20 – The Point!: Here we focus on patients/consumers and their perspectives. Yes, this is the entire point of what we do! In this episode we consider a doctor’s perspective on being labelled ‘difficult’ when she couldn’t get attention for her father’s needs in hospital, so began treating him herself. Yes, there has to be a better way.
Ref: “Good” Patients and “Difficult” Patients — Rethinking Our Definitions (Louise Aronson, M.D. 2013) N Engl J Med 2013; 369:796-797 DOI: 10.1056/NEJMp1303057
- www.cathybalding.com : Balding’s website and free QualityNews membership
- www.Hitchpodonline.com : for those that want to check out Jones’ podcast about Hitchcock
- https://omny.fm/shows/the-cant-bowl-cant-throw-cricket-show : Jones’ podcast about cricket
- https://cathybalding.podbean.com/category/cathy-balding/ : Balding’s interviews with quality leaders