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The Charter ( Medical Professionalism in the New Millennium.A Physician's Charter) did not deal with just the important relationship of ...

Wednesday, April 01, 2009

NHS's hospital from hell showcases performance measures

The British NHS is investigating how things could go so very wrong at one of their hospitals,the Stafford hospital. See here for the newspaper report that puts at least part of the blame on a situation where mindless adhering to quality targets may have caused deaths.

See also here for the story that has this quote:

...So what the government decided to do instead was make hospitals compete on things that mostly weren't related to clinical outcomes; things that could be easily measured, such as the four-hour wait in A&E. If you talk to clinicians, they'll say this has nothing to do with outcomes and doesn't improve the care that patients receive. You can find ways to fiddle the numbers to tick that box, and you can put resources in to try to meet the targets.

At a time when the incredibly bad care that is documented in the two above cited newspapers article was taking place the hospital was getting pretty good grades on its various performance measures.

One such target was "get the patients out of (A&E ) accident and emergency) to the wards in 4 hours.".If you thought there were problems with the U.S. "4-hour pneumonia rule"....

I have blogged before on Goodhart's law which says:

"Once a measure is made a target for the purpose of conducting policy it will loose the information content that would qualify it to play such a role".

While the mindlessness of treating to the quality measure is part of the problem at this NHS hospital there is much more wrong than that .See here for Health Care BS's take on the matter.

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