Blog 3: The Patient Perspective

             Unfortunately, adverse events occur in the health care industry very often. Adverse events can cause many problems for any health care organization. The occurrence of the situation goes from bad to worse when the patient is unhappy or displeased with the event. Once the patient is dissatisfied with the care they received, emotions run amok. When emotions are conveyed in the situation, it can only make the event harder to deal with especially if the patient is harmed (Ransom, Joshi, Nash, & Ransom, 2008, p. 250).When very serious adverse events occur and the patient is upset with their health care: legal battles, problems with regulation agencies, and media scrutiny are likely to arise (Ransom, Joshi, Nash, & Ransom, 2008, p. 250).

The reason the patient is receiving health care is to have an honest explanation of what is occurring with their body. Practitioners have the duty to help treat any patient’s health problems and to be honest with them. Therefore, it is recommended that the patient actively participate in all areas of their health care (Ransom, Joshi, Nash, & Ransom, 2008, p. 251). Often, the patient is the only one who knows what each specialist prescribes and diagnoses them. It is important that the patient relays the correct information to each practitioner. This way adverse events are less likely to occur. 

If the patient is completely or partially unaware about the adverse event occurrence, problems are less likely to occur for the health care organization. Admitting to an adverse event can be detrimental to the health care organization because it can be seen as admitting guilt in the court of law (Ransom, Joshi, Nash, & Ransom, 2008, p. 251). Therefore, many lawyers advise practitioners to never apologize for an adverse event (Ransom, Joshi, Nash, & Ransom, 2008, p. 251). Oftentimes, they even suggest that the practitioner stay mum when an adverse event occurs (Ransom, Joshi, Nash, & Ransom, 2008, p. 251).  Many patients file lawsuits to get the truth about what is occurring with their health care experience rather than to receive retribution (Ransom, Joshi, Nash, & Ransom, 2008, p. 251). Even if the patient is wrong about the adverse event occurrence, it may still cause damage to the practitioner’s practice and credentials. The perspective of the patient is the most important determinant to whether an adverse event has occurred because they may be able to tell that something is wrong with their health or the health care organization may not be telling the whole truth.

Reference:

Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book: Vision, Strategy, and Tools (2nd ed.). Chicago: Health Administration Press.

Blog 2: Wild Card

I recently read an article in the Orlando Sentinel called Osceola County offers free surgeries- overseas by David Breen and Marni Davidson. The article discussed Osceola County’s new healthcare plan for their government employees.  The healthcare plan will give employees the option to go overseas to have surgery. County officials are hoping that this option will cut healthcare costs by using less expensive international hospitals and doctors. Osceola County is the first employer including international care in their coverage, but for many years underinsured and uninsured people have received care outside the United States (Breen & Davidson, 2012). The plan will cover around 12 surgeries, including heart bypass, joint replacements, gastric procedures, and hysterectomies (Breen & Davidson, 2012). Even if Osceola County pays for travel expenses; they expect a lot of savings (Breen & Davidson, 2012). Medical practitioners have many concerns about the quality of care received internationally (Breen & Davidson, 2012). They worry about the follow-up service provided, the combination of surgery and flying, and risk of infections (Breen & Davidson, 2012).  

I believe that the international option will be offered more through insurance in the future. If the option is utilized, costs will be significantly lower. It is very important to lower costs in these tough economic times. Employers are trying to save money in any way possible. Lowering costs will also be favorable if the quality of care could be just as good as what is found in the United States. Also, many people may be inclined to receive surgery internationally when the the expenses are covered and they have the opportunity to travel. On the other hand, there is a possibility of lower quality. So the question stands: is the possibility of lowering costs worth the risk of quality?

People have certain expectations when they receive their healthcare which affects how they rate the quality they receive. One of the main components of quality is health outcomes. Health outcomes can be affected by language barriers. For instance, if the care providers do not understand English, they may not be able to properly care for the patient (Breen & Davidson, 2012). Doctors in the United States may deny care to someone who received surgery in another country because it is a liability if they did not perform the surgery (Breen & Davidson, 2012). 

If possible, I believe health is something that you should minimize any possible risks. A risk in your healthcare could be a life or death situation. If I were a patient considering surgery outside the country, I would decide not risk it even if the travel expenses were covered. I would be way too concerned about all the potential risks that could happen overseas, as well as, the care I would receive when I got back to the United States. I would want to make sure I would have coverage back in the United States in case anything was to happen after the surgery. I would rather pay the extra money to lower the risks of anything affecting my health before, during, or after my surgery. Without your health, what do you have?

Breen, D., & Jameson, M. (2012, May 19). Osceola County offers workers free surgeries — overseas. Orlando Sentinel. Retrieved May 20, 2012, from http://articles.orlandosentinel.com/2012-05-19/health/os-medical-tourism-osceola-county-20120519_1_joint-commission-international-foreign-hospitals-and-doctors-surgery

What does quality mean to you?

Quality ranges from low to high along a continuum. It is important to have high quality but it is extremely challenging to measure. Determining quality is dependent on an individual’s preferences and expectations. People expect a certain level of quality when they are receiving health care. In this instance, quality is often based on waiting times, communication, knowledge, and good health outcomes. Any variable can affect a person’s perception of the experience in a different way. Waiting ten minutes at the doctor can be considered very fast for one person or too slow for another. Therefore, everyone is going to perceive and evaluate quality differently and no one is going to have the same experience. 

The Healthcare Quality Book includes the six dimensions of quality: safe, effective, efficient, timely, patient-centered, and equitable (Ransom, Joshi, Nash, & Ransom, 2008, p. 5). These components work together to create an overall perception of quality. If someone interprets all of these characteristics in a positive way, their healthcare experience will be deemed to have high quality. Also, one characteristic may have a greater effect on determining an individual’s perception of quality than another. Many health organizations use these dimensions to create and achieve higher quality goals (Ransom et. al., 2008, p.5). Improving the quality of their organization can lead to a more successful business because more people will be satisfied with their experience at the facility.

I have been going to the dermatologist every few months for about two years for acne. The quality I receive differs each time I go. In the past, I have waited thirty minutes to see the doctor and other times I have waited less than five minutes. Sometimes the doctor spent two minutes consulting me and other times ten minutes. When the doctor went really fast, I would assume that the doctor was rushing and not really concentrating on my circumstance. In this instance, I felt that he did not care about treating me and just wanted to be done with his work. After the appointment, I would get frustrated paying the doctor fees for such a short period of time. Now I realize it is because he wanted to be able to see as many patients as possible and it was not necessary for him to spend much longer than that on my issue.

Overall, the quality of my experience has been great with this doctor. The results from the treatments the doctor gave me have been very favorable. I think that is the most important thing when determining the quality. If the health outcomes are what you want and expect, the quality will be perceived higher. If I was not being led to clearer skin, I would change doctors because I would not be getting the results I expected to occur. I realize people are going to have much worse health problems than acne. They are not always going to receive the outcome they want in healthcare because there is not always a cure or treatment. The quality of their experience will be perceived in other ways. Therefore, it is important to increase quality by having high standards of each dimension in your healthcare facility.

Reference:

Ransom, E. R., Joshi, M. S., Nash, D. B., & Ransom, S. B. (2008). The Healthcare Quality Book: Vision, Strategy, and Tools (2nd ed.). Chicago: Health Administration Press.