Metrics Massaging

[iish]

New York Times finally wrote an article on how hospitals massage metrics. While it's focused on the VA, we all know this brand of administrative medicine is practiced widely. I laud our colleagues at this VA for actually doing something about the injustice most of us only complain about.

Most entertaining is Shulkin's response. I wonder if he knew how the article would be framed? Or did he think it would be another piece by David Philipps about how he is an amazingly "in-touch" VA Secretary because he is a doctor that sees patients.

It's time for a national conversation on the unintended consequences of metrics-based medicine and high time we as doctors define quality care.

At Veterans Hospital in Oregon, a Push for Better Ratings Puts Patients at Risk, Doctors Say

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[emergentmd]

1. Midlevels clicking on patients within 5 minutes but no one sees the patients for 2hrs puts the time to be seen at 5 minutes

2. Charting stuff that we never did to meet metrics

3. Pan ordering 20 lab tests for a 25 yo healthy person with fever and sore throat and throwing Vancomycin +/- Zosyn within 1 hr

4. Pts going straight to CT and Pan labs for anything that smells like a stroke

Whats new? Anyone suprised

 

[iish]

Not in the least surprised. Same everywhere.

What do we do about this? We've let the specialty be overrun by administrative goons committing fraud. If these were accountants massaging numbers the way they do, some would end up in jail.

 

[RoyBasch]

Am I the only person who was hoping this was post about things you can do to help your metrics?

 

[RoyBasch]

3. Pan ordering 20 lab tests for a 25 yo healthy person with fever and sore throat and throwing Vancomycin +/- Zosyn within 1 hr

I encounter this one at least once a week with the mid levels for pharyngitis patients. I then have to fight the hospital sepsis coordinators and explain why the viral pharyngitis dc'd home is not a sepsis protocol "fall out." They are not satisfied with my explanation.

 

[TooMuchResearch]

I encounter this one at least once a week with the mid levels for pharyngitis patients. I then have to fight the hospital sepsis coordinators and explain why the viral pharyngitis dc'd home is not a sepsis protocol "fall out." They are not satisfied with my explanation.

Point them to CMS. If the diagnosis isn't sepsis, it's not a fall out.