Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Improving the Quality of Medical Care and Other Topics on the EMS Garage from the 2012 EMS Expo

 

 
Chris Montera (the man behind the EMS Garage), Pat Songer (Director of EMS at Humboldt General Hospital, Winnemucca, NV), Matt Womble (Principal at Womble Consulting), and I were on a video podcast from the 2012 EMS Expo in New Orleans.

You can watch the video podcast at the ProMed Network page here.

There may have been some sort of plan for an initial topic, but as Chris mentions, the EMS Garage wanders.

We started by discussing Burning Man.[1] I am the only one who has not been there.

We switched to patient satisfaction scores.[2]

But the most important topic was improving the quality of patient care by being able to discuss errors without fear of punishment.[3]

 

Image credit.
 

Some people keep trying to get rules that have been set up to prevent lawyers from being able to troll for torts by having access to this privileged information.

Would lawyers feel the same way about having to divulge their conversations with clients, rather than have it considered privileged information?

Some people just do not understand that the satisfaction of finding out some bit of information now comes at the price of having all similar information kept secret in the future.

Some people just do not understand that the satisfaction of finding out some bit of information now comes at the price of not protecting patients from similar errors in the future.
 

Discouraging isolated episodes of negligent care without lifting institutional performance more broadly would surely be a Pyrrhic victory for tort law’s deterrent effect.[4]

 

The tort system does not lead to a decrease in errors, or in improved protection for patients, but working to identify and eliminate errors does provide the opportunity to protect patients. As Matt Womble keeps stating – We can’t expect other people to do our job for us. We need to educate people about what we do and how to do it better.

We need to fix our own quality problems, because the lawyers certainly are not improving the quality of medicine. If we won’t fix our quality problems, why should we expect non-medical people to fix our problems?

We feel that we have to do something, and the tort system is already in place, but where is the evidence that the tort system improves outcomes for patients.
 

You can watch the video podcast at the ProMed Network page here.

Footnotes:

[1] Burning Man
Wikipedia
Article

[2] EMS Garage on Press Ganey – Should We Reward High Scores
Wed, 27 Apr 2011
Rogue Medic
Article

[3] What if confidential information, provided to protect patients, were no longer confidential?
Sat, 30 Jun 2012
Rogue Medic
Article

[4] Relationship between quality of care and negligence litigation in nursing homes.
Studdert DM, Spittal MJ, Mello MM, O’Malley AJ, Stevenson DG.
N Engl J Med. 2011 Mar 31;364(13):1243-50.
PMID: 21449787 [PubMed – indexed for MEDLINE]

Free Full Text from New England Journal of Medicine

Tort theory suggests that litigation induces defendants to be more careful and warns others to take precautions.28 But to be effective, this deterrent function logically requires a degree of precision.

CONCLUSIONS
The best-performing nursing homes are sued only marginally less than the worst-performing ones. Such weak discrimination may subvert the capacity of litigation to provide incentives to deliver safer care.

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