Enhancing quality in GI health care
How do you/we choose from all those who wish to serve us, whether restauranteurs, plumbers or doctors? How do we know which or who is good, or even excellent? Locally we can rely on our own experience and the recommendations of friends. But it is more difficult away from home. Some things like restaurants and hotels (and their guides) have grading systems, and the web is full of reviews by consumers that may influence our decisions. Price is a factor also. But choosing a doctor is much more difficult.
As I get older I begin to think more like a potential patient than a provider. How can I be sure of getting good treatment if I am dragged off a distant golf course in an emergency? Surely, hospitals only permit competent specialists to practice in their facilities? A recent survey suggests that is not always true, at least for one procedure that I know well. “A survey of Credentialing for ERCP in United States”. Published in Gastrointestinal Endoscopy, on line March 2017. I have written an editorial for Clinical Gastroenterology and Hepatology on how that situation might be improved, but the issue is much broader, and some of the same remedies apply.
Firstly, patients deserve to know more about their potential doctors, which means that we should all be comfortable collecting our performance data, and making it available when requested by anyone interested (patients, payers and even plaintiff lawyers). My repeated cry for gastroenterologists to keep “report cards” has been largely ignored, so far. There is a national system (GIUQIC) for reporting and benchmarking performance in the commonest endoscopic procedures, colonoscopy and upper endoscopy, but not for ERCP, by far the most hazardous. Most crucial is the fact that reporting is voluntary, and the less competent are unlikely to participate.
Of course, the overarching answer is for all of us to strive continuously to improve the quality of practice. There are plenty of erudite books, journals and meetings to help us, but there are few resources focused acutely on enhancing the patient experience.
Thus, I was recently pleased to join the board of SE HealthcareQualityConsulting, a company which provides resources to enhance safety and efficiency in many specialist domains. I have helped to develop the GI-specific Physician Empowerment suite of tools, designed to measure and improve patient experience and clinical effectiveness.
I hope that you will take a look at the “GI bundle” at www.sehqc.com.
If you want to hear more, feel free to contact me at firstname.lastname@example.org or call Stacia Pearce at 717.805.7829