Gone are the days of the black doctor bag and house calls. Modern medicine relies on high tech tools, super pharmaceuticals and evidence-based practice protocols. Still, with all these amenities, modern medical care does not guarantee improved patient outcomes. According to a recent study published in the March 15, 2011 edition of The Annals of Internal Medicine, this fact is not shocking.
Viewing patient outcomes in acute myocardial infarction (AMI) cases, researchers from Yale University analyzed records from 11 of America's hospitals that either ranked in the top or bottom in risk standardized mortality rates as determined by the Centers for Medicare & Medicaid Services. In the study, 158 medical care professionals were interviewed and their responses analyzed from the 11 facilities.
Researchers found that those hospitals in the high-performing and low-performing groups were substantially different in various areas, including organizational values and goals, senior management involvement, staff knowledge and expertise, and communication and coordination among groups. Ultimately, the group concluded that evidence-based protocols and processes were less significant than hospitals having an organizational culture that supported efforts to improve AMI care.
In light of various health care reform and patient safety initiatives, the Annals report places significant emphasis on communication and staff commitment. These findings are not surprising, given that in the July 2010 issue of the Journal of General Internal Medicine, researchers revealed that the "disconnect" between patient beliefs and doctors' perception related to poor communication and increased risks for poor patient outcomes.
While medical research has decoded the human genome, reduced invasive surgery risks, and developed targeted cancer therapies, medical facilities and practitioners have adopted various practices to improve efficient operations with maintaining records and coordinating staff. In a service industry besieged by malpractice litigation, health insurance limits and crowded waiting rooms, delivery of services is directly related to hospital culture. The Annals article clearly proves that facilities without adequate support from administration and staff have poorer patient outcomes.
While federal agencies test the full extent of health care reform and offer incentives regarding health care affordability and safety, some medical foot soldiers, such as doctors, nurses and techs, must handle the day-to-day realities of pharmaceutical shortages, inconsistent standards of care and strict financial guidelines. The knowledge that shifts in hospital culture can help save lives may be enough for some facilities to make the right changes.